Bicanalicular Silicone Tube Intubation Research Articles

Endoscopic dacryocystorhinostomy with and without bicanalicular silicone tube in patients with a small lacrimal sac: a comparative study.

To establish whether bicanalicular silicone tube intubation is required during endoscopic dacryocystorhinostomy (En-DCR) for treating chronic dacryocystitis with a small lacrimal sac. In total, this study enrolled 264 patients diagnosed with unilateral chronic dacryocystitis with small lacrimal sacs via computed tomography-dacryocystography that underwent En-DCR from March 2016-September 2020. Patients were randomized into two treatment groups, with those in group A undergoing tubes intubation and those in group B not undergoing this procedure. The tubes were removed 3 months post-operation in group A. Surgical outcomes and related complication rates were then compared. This study included 242 patients, including124 and 118 in groups A and B, respectively. At the three-month follow-up time point, 12.90% of patients in group A exhibited ostial granulation tissue, with this frequency with no differences observed in group B (11.86%). At 6 months post-surgery, 80.65% of patients in group A and 72.88% of patients in group B exhibited successful surgical outcomes, with no significant differences between groups. At 9 months postoperatively, the overall effective success rate was 60.74%, and the success rate was significantlyhigher in group A relative to group B (group A: 75.81%; group B: 44.92%). There were no failed patient outcomes observed as of the 12-month follow-up time point. While En-DCR-based treatment of chronic dacryocystitis in those with smalllacrimal sacs did not yield satisfactory outcomes with respect to the overall effective success rate, these results suggest that intraoperative intubation may improve success rates in long-term follow-up.

Correction: Retrospective analysis of bicanalicular lacrimal silicone tube intubation in patients with congenital nasolacrimal duct obstruction: a long-term follow-up study.

Correction: Retrospective analysis of bicanalicular lacrimal silicone tube intubation in patients with congenital nasolacrimal duct obstruction: a long-term follow-up study.

Retrospective Analysis of Bicanalicular Lacrimal Silicone Tube Intubation in Patients with Congenital Nasolacrimal Duct Obstruction: A Long-term Follow-up Study.

Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora in the first year of life. In addition to conservative therapy, there are several invasive methods available. The aim of this retrospective study was to conduct a long-term follow-up of bicanalicular lacrimal duct intubation as the primary intervention in a large cohort of patients with CNLDO. The electronic medical records of 487 patients with CNLDO who underwent bicanalicular tube intubation were reviewed. To determine the long-term outcomes, a telephone interview was conducted. A total of 328 eyes of 235 patients were included in the study. The median average follow-up period was 6.67 (5.58 - 8.67) years. At the time of the survey, 218 patients (92.8%) were symptom free. Mean patient satisfaction with surgical outcome was 10/10. To our knowledge, this study provides the longest follow-up of the largest patient cohort in the literature consisting of patients who underwent probing with bicanalicular lacrimal silicone tube intubation as a primary intervention for CNLDO. This study showed a high long-term postoperative success rate, with high postoperative satisfaction, few complications, and a low need for reintervention.

Comparison of the surgical outcomes of endoscopic dacryocystorhinostomy in chronic dacryocystitis with or without previous bicanalicular silicone tube intubation

AimsTo compare the outcomes of endoscopic dacryocystorhinostomy (En-DCR) in chronic dacryocystitis (CD) with or without previous bicanalicular silicone tube intubation (BSTI), and investigate whether previous BSTI influenced postoperative outcomes. MethodsWe conducted a retrospective review of medical records of CD patients (group A) who had previously undergone BSTI for nasolacrimal duct stenosis and an age- and sex-matched control group of CD patients (group B) without previous intubation receiving En-DCR from November 2017 to January 2022. Sixty-one patients (61 eyes) were included in group A and age- and sex-matched 122 patients (122 eyes) in group B. Dacryocystic parameters were measured by computed tomography-dacryocystography and surgical findings were recorded during surgeries. The surgical success rates of the two groups were compared at 12 months post-operation. ResultsThe mean horizontal, sagittal, and vertical lengths were 6.06 ± 1.24, 6.03 ± 1.44, and 8.05 ± 2.00 mm, respectively, in group A and 6.33 ± 1.25, 6.26 ± 1.19, and 10.40 ± 2.45 mm, respectively, in group B. There were no differences in the horizontal or sagittal parameters between the two groups. The vertical parameter in group A was significantly lower than that in group B. Scar formation in the sac was observed in 54 patients in group A but was absent in group B. At 12 months postoperatively, the anatomical and functional success rates were 88.52 % and 85.25 %, respectively, in group A and 92.62 % and 89.34 %, respectively, in group B, with no difference between the two groups. ConclusionPrevious BSTI reduced dacryocyst vertical parameter and caused dacryocyst scar formation but did not affect postoperative En-DCR efficacy.

Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study.

The dacryocystorhinostomy (DCR) procedure is linked to a high success rate; however, cases of tearing recurrence are not rare and should be managed efficiently. Thus, evaluating cases of DCR failure allows highlighting the factors significantly impacting the results in order to realize better controlled primary surgeries. Twenty-eight patients were operated in our Otolaryngology Department for endoscopic revision of DCR failure between January 2019 and June 2022. Their clinical presentation, postoperative evolution, and findings of the primary and revision surgeries were assessed until the actual follow-up. The first surgery was based on an external approach in 17 patients and the bicanalicular silicone tube intubation was kept for a mean of 4.25 months. The recurrence delay varied from 0.5 to 9 months. Revision surgery revealed synechia in 10 patients, a completely closed DCR ostium in 22 patients (78.57%) by mucosal scarring and granulation, and lacrimal sac fibrosis in 16 patients (57.14%). A significant correlation was found between maintenance of the silicone intubation tube greater than or equal to 3 months and lacrimal sac fibrosis (P=0.016<0.05). Thus, better controlled primary surgeries with optimal exposure, wild marsupialisation of the lacrimal sac and no longer systematic bicanalicular intubation which should be dedicated to difficult anatomies and canalicular affections should guarantee better functional results.

Endoscopic dacryocystorhinostomy with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent incarceration.

To investigate the feasibility of endoscopic dacryocystorhinostomy (En-DCR) with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent (NDS) incarceration. En-DCRs were performed on 44 chronic dacryocystitis patients (46 eyes) secondary to NDS incarceration from April 2016 to October 2022. The granuloma and scar tissues were separated, and the removal of NDS incarceration was achieved during the surgery; the flap of the lacrimal sac was trimmed and anastomosed with nasal mucosal, a bicanalicular silicone tube was implanted, and lacrimal size and condition were assessed. The tube was removed 3mo after surgery. During the final follow-up of 12mo when the surgery was completed, the complications and the rates of surgical success were assessed. This study covered 40 patients (42 eyes). Intraoperatively, it was found that the lacrimal sac became small, and the sac wall had granulation and scar tissue attached to the incarcerated NDS in all eyes. At 12mo after surgery completed, the rates of the functional and anatomical success reached 80.95% (34/42) and 83.33% (35/42), respectively. Under the effect of intranasal ostial closure, seven eyes failed to achieve anatomical success. No serious complications (e.g., visual impairment, sinusitis, and orbital fat prolapse) was observed. With the success rate over 80% and no serious complications, En-DCR with bicanalicular silicone tube implantation is effective in treating chronic dacryocystitis secondary to NDS incarceration.

Comparison of Endoscopic Dacryocystorhinostomy Outcomes With or Without Bicanalicular Silicone Tube Intubation in Acquired Lacrimal Sac Mucocele.

This paper was established to validate the necessity of bicanalicular silicone tube intubation (BSTI) in patients with acquired lacrimal sac mucocele (ALSM) receiving endoscopic dacryocystorhinostomy (DCR). In total, 92 patients (92 eyes) diagnosed with ALSM undergone endoscopic DCR from November 2016 to December 2021 were recruited for our research. Patients were allocated into 2 equal treatment groups: group A (patients undergoing BSTI) and group B (patients not receiving this procedure). The tubes were removed 2 months postoperation in group A. Surgical outcomes and related complications were evaluated 12 months postoperation. Ultimately, this study included 83 patients with ALSM, consisting of 43 patients in group A and 40 patients in group B. All patients exhibited notable mass shrinkage with the opening of the lacrimal sac during the surgery and the swelling in the lacrimal sac area was completely relieved within 5 days postoperation. At the 12-month follow-up, no distinct difference was observed in the anatomic success rate between the 2 groups (group A: 93.0%; group B: 90.0%) ( t = 0.010, P > 0.05). However, patients in group A presented higher functional success rates (90.7%) in contrast to those patients in group B (72.5%) ( t = 4.635, P < 0.05). In both groups, the failure of the lacrimal passage reconstruction was attributed to granulation tissue formation or scar formation at the ostium. No sac mucocele recurrence occurred during the follow-up. Endoscopic DCR treatment for ALSM achieves satisfactory postoperative effects without recurrence, and BSTI may improve the functional success rate.

Effect of intubation in patients with functional epiphora after endoscopic dacryocystorhinostomy.

To investigate the effect of bicanalicular silicone tube intubation (BSTI) in the treatment of functional epiphora after endoscopic dacryocystorhinostomy (En-DCR). Clinical data of 84 patients (95 eyes) with functional epiphora after En-DCR were retrospectively analyzed. Functional epiphora was confirmed as persistent or recurrent epiphora by fluorescein dye disappearance test (FDDT), lacrimal irrigation test, as well as endoscopic examination. Secondary BSTIs were recommended for patients with functional epiphora. These tubes were removed 1mo after surgery. Functional success and associated complications were assessed after 2y of follow-up. Seven patients (9 eyes) refused intervention, 5 patients (6 eyes) did not complete postoperative follow-up, and 1 patient (1 eye) developed tube prolapse within 1mo after surgery. Seventy-one patients (79 eyes) were included at last. Functional success ratios at six months, one year, as well as two years post-operation were 94.9% (75/79), 92.4% (73/79), and 91.1% (72/79), respectively. Three eyes presented with punctal slitting (2 eyes without epiphora), 1 eye with proximal canaliculus slitting, 1 eye with canaliculus stenosis and 4 eyes with still present functional epiphora without detectable abnormal at the last follow-up. Secondary intubation is an effective procedure with low recurrence probability for functional epiphora after En-DCR. Punctal and canaliculus injury are the main tube-associated complications after secondary intubation.

SİLİKON TÜP ENTÜBASYONLU EKSTERNAL DAKRİYOSİSTORİNOSTOMİ; UZUN DÖNEM SONUÇLARI

Aim: To present the long-term results of bicanalicular silicone tube intubation combined with external dacryocystorhinostomy (EDRS) in-patient with nasolacrimal duct obstruction (NLDO)&#x0D; Methods: Long-term results of 169 eyes of 169 patients who underwent external dacryocystorhinostomy between January 2010 and December 2020 in our clinic were evaluated, retrospectively. On the postoperative 1st day, 10th day, 1st month, 3rd month, 6th month, 9th month, 12th month, and last visits, the patients were evaluated. Especially on the postoperative 1st day for signs of infection, the position, tension, and placement of the silicone tube, and the presence of epiphora. Silicone tubes of the patients were removed 6 months after surgery. Surgical success; The disappearance of the patient's symptoms was evaluated as the lacrimal drainage open.&#x0D; Results: 102 of our cases were female and 67 were male. The mean age-standard error was 55,48±1,36. Our average follow-up-standard error was 47,83±2,27 months. Surgical failure occurred in two of our patients. These cases were who were severe bleeding occurred during surgery and flaps were formed with difficulty. In these cases, revision surgeries were performed with an internal approach and surgical success were achieved in both of them. In our patients, who underwent bicanalicular silicone tube intubation surgery combined with external dacryocystorhinostomy, the surgical success rate was 98,76% in the first operation and 100% in the second operation.&#x0D; Conclusions: Considering the long-term results of bicanalicular silicon tube intubation combined with dacryocystorhinostomy operations, it is the most effective surgical method with the highest success rate in nasolacrimal canal obstruction.

Comparison of the results between monocanalicular and bicanalicular silicone tube intubation in children with congenital nasolacrimal duct obstruction

Comparison of the results between monocanalicular and bicanalicular silicone tube intubation in children with congenital nasolacrimal duct obstruction

Clinical Significance of Biofilm on Silicone Tubes Removed From Patients With Nasolacrimal Duct Stenosis

To determine the relationship between the optical density of biofilms on silicone tubes and surgical outcomes. A total of 43 silicone tubes from 33 patients with nasolacrimal duct stenosis were enrolled at 6 months after bicanalicular silicone tube intubation. The removed silicone tubes were divided into 2 segments. One segment of silicone tube was cultured while the other segment was used to measure optical density of biofilm. Each segment was divided into 3 pieces according to average normal human nasolacrimal anatomy. The first piece was located from puncta to lacrimal sac. The second piece was inside the nasolacrimal duct. The third piece was in the nasal cavity. Surgical outcome was evaluated at postoperative 12 months based on Munk score and fluorescein dye disappearance test. A total of 31 (72.1%) patients were surgically successful while 12 (27.9%) patients had surgical failure with persistent epiphora. In the second piece of silicone tube, the mean optical density of biofilm was 0.2654 nm in the surgical success group and 0.4472 nm in the surgical failure group. These results showed statistically significant (P < 0.01) difference. The most frequently isolated organism was Staphylococcus aureus in the surgical success group (7 of 31 patients, 22.6%). It was Pseudomonas aeruginosa in the surgical failure group (6 of 12 patients, 50%). This is the first study that determines the relationship between biofilm on silicone tube and surgical outcome. Biofilm formed on silicone tubes in nasolacrimal duct might cause surgical failure.

Monocanalicular and bicanalicular silicone tube intubation results in patients with congenital nasolacrimal duct obstruction

Monocanalicular and bicanalicular silicone tube intubation results in patients with congenital nasolacrimal duct obstruction

Monocanalicular and bicanalicular silicone tube intubation results in patients with congenital nasolacrimal duct obstruction

Monocanalicular and bicanalicular silicone tube intubation results in patients with congenital nasolacrimal duct obstruction

A simplified approach for bicanalicular silicone tube intubation for the management of canalicular lacerations

We report the surgery of a bicanalicular laceration of the lacrimal system in which a simplified annular intubation of silicone tube had been used. After passing the silicone tube through the canalicular system guided by the prolene suture, the tip of the silicone tube was stuck and advancing it through the lach - rymal system was not possible. Then this threaded 6-0 prolene suture was tied to the wall of the silicone tube at the tip and pulled gently from the opposite side. The silicone tube was threaded easily with no obstacle. We hope that our result in this case will create an alternative way for surgeons while repairing canalicular system lacerations

Outcome of External Dacryocystorhinostomy with Bicanalicular Silicone Tube Stenting

Objective: To evaluate the clinical outcomes of patients with nasolacrimal duct obstruction treated with external dacryocystorhinostomy and bicanalicular silicone intubation stenting. Methods: The patients were grouped as follows: Group 1, complicated cases with intubation; Group 2, complicated cases without intubation; Group 3, non-complicated cases with intubation; and Group 4, non-complicated cases without intubation. Cases without epiphora, demonstrated with freeflow lacrimal irrigation, were deemed as successful cases. Failure was defined as lack of any improvement of the symptoms. Complications related to the surgical procedure were also investigated. Results: In total, 223 external dacryocystorhinostomy procedures were performed on 201 patients. In the evaluation of complicated cases, the success rates in Groups 1 (silicone tube stenting group) and 2 (non-stenting group) were 90.9% and 77.8%, respectively (p 0.05). In 15 (13.8%) out of 108 cases who had had bicanalicular silicone tube intubation, stent displacement was observed. Lower and upper punctal synechiae developed in 1 of 6 cases with punctal complications. In 14 failed cases, successful results were obtained with external DCR and bicanalicular silicone stent intubation. Conclusion: Stenting in complicated cases increases the success rates of dacryocystorhinostomy significantly. However, we detected that in complicated cases, especially in the absence of anterior flaps, stenting does not increase success rates, contrary to posterior flap loss. No effect of stenting in non-complicated cases on surgical success rates could be demonstrated. (JAREM 2014)

A Case of Acquired Lacrimal Fistula Caused by Silicone Tube Remnant

Purpose: To report a case of acquired lacrimal fistula caused by silicone tube remnant. Case summary: A 56-years-old female who suffered from purulent discharge in inner skin of the right lower eyelid visited our clinic. Lacrimal fistula was found in the skin at the medial side of the right lower eyelid. The patient reported that she had a silicone tube intubation operation 3 years prior due to a nasolacrimal obstruction of right eye. On syringing test, saline solution and purulent discharge were drained from the fistula skin opening and there was no nasolacrimal obstruction. After admission, antibiotic treatment and potadine soaking dressing were performed to facilitate spontaneous closing of the lacrimal fistula. However, the lacrimal fistula relapsed and lacrimal fistulectomy and bicanalicular silicone tube intubation were performed. During surgery, silicone tube remnant material not totally extubated at the lacrimal sac was found which we removed. Postoperatively, systemic antibiotic therapy was administered and the chronic inflammation improved. Conclusions: We report a case of lacrimal fistula caused by silicone tube remnant in the lacrimal sac. Acquired lacrimal fistula caused by a silicone tube remnant can be treated by fistulectomy and silicone tube remnant removal. J Korean Ophthalmol Soc 2014;55(5):746-749

One-stitch anastomosis through the skin with bicanalicular intubation: a modified approach for repair of bicanalicular laceration.

To evaluate the efficacy and safety of one-stitch anastomosis through the skin with bicanalicular silicone tube intubation in repairing of bicanalicular laceration. The clinical data of 15 consecutive patients with both superior and inferior canalicular laceration in one eye who underwent surgical repair using one-stitch anastomosis through the skin and bicanalicular stent were retrospective studied. All the operations were performed under surgical microscope, 5-0 silk sutures were used and were with bicanalicular silicone tube (diameter was 8mm) intubation, for one lacerated canaliculi one-stitch anastomosis through the skin. The stents were left in place for 3 months postoperatively and then removed. The follow-up period was 3 - 36 months (average 14 months). In 15 patients, 13 patients were cured entirely, 1 patient was meliorated, 1 patient with no effects. All patients had got good recovery of eyelid laceration with no traumatic deformity in eyelid and canthus. Complication was seen in one case, for not followed the doctor's guidance to come back to hospital to had the suture removed on the 7(th) day after operation, when he came at the 15(th) day, the inferior canalicular wall and eyelid skin were corroded by the suture caused 2mm wound, and the inside silicone tube was exposed, a promptly repair with 10-0 nylon suture was done, the wound healed in a week. There were no early tube protrusions and punctal slits in the patients. One-stitch anastomosis through the skin with bicanalicular silicone tube intubation is a good method in repair of bicanalicular laceration in one eye, the cut ends can be anastomosed directly, and with excellent cosmetic results, it is acceptable for the patients. For there is no suture remained in the wound permanently, so there is no suture-related granuloma which may cause obstruction or stenosis of canaliculi. It is simple, economical, effective and safe.

Our endoscopic transcanalicular multidiode laser dacryocystorhinostomy results through bicanalicular silicone tube intubation

This study aims to evaluate the results of transcanalicular multidiode laser dacryocystorhinostomy (TMDL-DCR) through bicanalicular silicone tube intubation (BSTI). Between September 2011 and March 2012, treatment-naïve 43 eyes of 43 patients (24 males, 19 females; mean age 53.6±4.1 years; range 37 to 69 years) who presented with the complaint of watery eyes with a nasolacrimal duct obstruction and underwent TMDL-DCR through endoscopic silicone tube were included. Patients were assessed postoperatively. During follow-up, changes from baseline in signs and symptoms and the duration of intubation were recorded. The mean age of the patients was 53.6 years (range, 37 to 69 years). The mean follow-up was 19.4±2.2 months (range, 18 to 23 months). The mean duration of surgery was 16.5 min (range, 11 to 32 min). Epiphora was seen in seven patients following surgery. Nasolacrimal duct was open in 36 patients. The success rate was 83.7%. Transcanalicular multidiode laser DCR through BSTE is an effective and safe method in the management of nasolacrimal stenosis.

Comparison of Endolaser Dacryocystorhinostomy and External Dacryocyctorhinostomy Results

Aim of this study is to compare endoscopic endolaser dacryocystorhinostomy (DCR) with bicanalicular silicone tube intubation (BSTI) and external DCR results. The records of patients who underwent DCR operation were retrospectively evaluated. Patients were invited to the controls in the postoperative period. In their follow-ups, changes in symptoms and findings, the duration of the tubes remain in place were recorded. 132 eyes of 124 patients were included in the study. 63 eyes of 61 patients were applied endolaser DCR (Group 1) and 69 eyes of 63 patients were applied external DCR (Group 2) (p>0.05). Patients were followed 6.6 months (2-11 months) and 5.9 months (2-7 months) in groups 1 and 2, respectively (p>0.05). Mean age of patients was 51.2 years old (range between 27-81 years) and 48.5 years old (range between 25-82 years), respectively (p>0.05). Irritative symptoms and findings were regressed and no recurrence was observed during follow-up in 54 patients (85.7%) and 64 patients (92.8%) in groups 1 and 2, respectively (p>0.05). Endolaser DCR + BSTE application seems to be an effective method in lacrimal stenosis.

One-stitch anastomosis through the skin with bicanalicular silicone tube intubation for treatment of superior and inferior canalicular lacerations

Objective To evaluate the efficacy of one-stitch anastomosis through the skin with bicanalicular silicone tube intubation to treat the bicanalicular lacerations.Methods Retrospectively,11 consecutive patients with both superior and inferior canalicular lacerations in one eye who underwent surgical repair using one-stitch anastomosis through the skin and bicanalicular stent were included.All the operations were performed under surgical microscope,5-0 silk sutures were used and bicanalicular silicone tubes (the diameter was 0.8 mm) were intubated,with one lacerated canalicula one-stich anastomosis through the skin.The stents were left in the place for 3 months postoperatively and then were removed.The follow-up period was 3 ～36 months(average 14 months).Results In 11 patients,9 patients were cured entirely,1 patient were meliorated,1 patient had no effects.All the patients had got good recovery of eyelid laceration without traumatic deformity in eyelid or canthus.There was no early tube protrusion or punctal slits in the patients.Conclusion One-stitch anastomosis through the skin with bicanalicular silicone tube intubation is a good method in repair of bicanalicular laceration in one eye.The cut ends could be anastomosed directly.No suture remained in the wound permanently.There was no suture-related granuloma which might cause obstruction or stenosis of canaliculi. Key words: Laceration, canalicular, superior and inferior; Repair; Anastomosis, through the skin, one stitch; Intubation, bicanalicular