Treatment Of Dacryocystitis Research Articles

Superior Nasal Septal Deviation as a Contributing Factor for Dacryocystitis.

Background Dacryocystitis (DC) is a disease most often caused by an obstruction of the nasolacrimal duct, leading to over-accumulation of tears in the lacrimal sac, epiphora, and aseptic inflammation. External and endoscopic dacryocystorhinostomy (DCR) aims to restore the tear pathway by creating a bypass from the lacrimal sac to the nose. The aim of this study is to investigate superior nasal septal deviation as a possible contributing factor in the incidence and treatment of dacryocystitis. Methods This retrospective study included 36 patients surgically treated for chronic dacryocystitis from September 2019 to September 2024. Results Twenty-eight out of the 36 studied patients (77.8%) werefemales. The average age of all patients was 66.8 years, with 69.4% being in the 50-70 years age groupwhile 30.6% being older than 70 years. Superior nasal septal deviation was present in all patients, with 18 (50%) cases being towards the side of the DC and 11(30.6%) away from the side of the DC. In seven cases (19.4%), the septum was S-shaped. In none of the cases in which the endoscopic approach was used was a septoplasty necessary. Concha bullosa was observed in five cases (13.9%) and was treated in all. A total of 32 patients were treated endoscopically (88.9%)and four (11.1%) by the Toti external approach method. The intraoperative microbiologic culture was positive in a total of nine cases (25%), five being coagulase-negative Staphylococci (13.9%), two being S. pneumoniae (2.8%), and one each of S. aureus (2.8%) and Pseudomonas maltophilia (5.6%). A re-stenosis was observed in five patients (13.9%). Conclusion Superior nasal septal deviation is an emerging factor both for the incidence of dacryocystitis and the development of re-stenosis after dacryocystorhinostomy. Further studies are needed to find the exact types of nasal septum deviations carrying the greatest risk for disease development, as well as the role of septoplasty in the result of treatment.

Анализ эффективности лечения врожденного дакриоцистита у детей до 1 года

Aim. To evaluate the effectiveness of surgical treatment tactics and reflect the fundamental points in the treatment of dacryocystitis in children under one year. Methods. The study was carried out in Tyumen regional clinical Hospital No. 2 for the period from 2019 to 2021. Seventy-nine children diagnosed with dacryocystitis of the newborn were examined. Results. According to the examination and treatment data, the age structure of the population was revealed: up to 3 months – 21 %, up to 6 months –17 %, up to 12 months –52 %. Primary probing of the tear ducts gave a positive result in 100 % of cases (86 eyes), repeated probing was required in 30 % of cases (38 eyes). Complete recovery with repeated manipulations was in 89.5 % (34 eyes). In 4.4 % (4 eyes) additional lacrimal pathways bougienage with silicone thread was required. Conclusion. The results of the study demonstrate the effectiveness (100 %) of primary probing under general anesthesia; under the age of one year it is the optimal method of treatment. Key words: dacryocystitis of the newborns; probing of the nasolacrimal canal.

Способ профилактики рубцового заращения дакриостомы

Purpose. To evaluate the effectiveness of the developed method for preventing cicatricial fusion of dacryostomy (DS) after endonasal endoscopic dacryocystorhinostomy. Material and methods. The study included 58 patients (58 eyes) with chronic purulent dacryocystitis who underwent endonasal endoscopic dacryocystorhinostomy. All patients were divided into 2 groups: the main group (29 people) – at the final stage of the operation, a glove turunda was installed between the middle nasal concha and the cavity of the lacrimal sac under the control of a rhinoscope; comparisons (29 people) – they underwent surgical treatment according to standard technology. The criteria for evaluating the effectiveness of surgical treatment was the study of active and passive patency of the formed lacrimal ducts. Turunda was removed 6–7 days after surgery in patients of the main group and fibrinous clots in the area of the formed anastomosis in patients of the comparison group. Results. One month after the operation, all patients of the main group and the vast majority of patients (27 people – 93 %) of the comparison group showed good patency of the formed anastomosis. While 2 people of the comparison group (7 %) had contact between the DS mucosa and the middle turbinate, which led to the formation of a cicatricial strand of the “web” type and a recurrence of the disease by 3 months after the operation. In the period of 6 months, these patients were operated again. Conclusion. The developed method for the prevention of cicatricial fusion of DS using glove turunda after surgical treatment of dacryocystitis is an effective way to restore and maintain the full function of lacrimal drainage through natural pathways with a follow-up period of 12 months. Keywords: dacryostomy, infection prevention, chronic suppurative dacryocystitis.

Изучение антифибротической активности пирфенидона при дакриоцисториностомии (экспериментальное исследование)

One of the main reasons of failure in surgical treatment of dacryocystitis is cicatrical closure of the ostium. Considering controversial data on efficacy and safety of antifibrotic methods currently employed during dacrycystorhinostomy, searching for new ways to prevent fibrosis remains one of the main directions of research in dacryology. Pirfenidone, a small-molecule agent, was demonstrated to have a pronounced antifibrotic effect in experiments both in the eye and various other organs. Aim. To experimentally evaluate the antifibrotic effect of pirfenidone in dacryocystorhinostomy. Material and methods. 18 shinshilla rabbits were used in the current study. Subjects underwent modified dacryocystorhinostomy followed by 0,15 or 0,3 mg/ml pirfenidone injection circumostially. Animals were divided into groups based on pirfenidone dosage used. Control group animals received no injection. Rabbits were killed on the 7th (6 rabbits), 14th (6 rabbits) and 28th day (6 rabbits) following surgery. Ostium patency was evaluated using lacrimal irrigation and morphologically once the animal was killed. Ostium tissue samples were analyzed histologically. Results. Cicatrical closure of the ostium was observed in 4 subjects from control group on days 14 and 28 following surgery. The most pronounced fibrotic changes were also noted in tissue specimens obtained from these rabbits. Fibrotic changes in groups 1 and 2 were notably less severe than in control group. Conclusion. Data obtained in the current study evidences high antifibrotic efficacy of pirfenidone. This necessitates further research of pirfenidone use in dacryocystorhinostomy. Key words: dacryocystorhinostomy, ostium closure, dacryostoma, pirfenidone, antifibrotic therapy.

A new method of endonasal dacryocystorhinostomy

Objectives - to improve the quality of surgical treatment of patients with chronic dacryocystitis. Material and methods. Six people participated in the study. All the examined and operated patients were diagnosed with chronic dacryocystitis. The patients' examination included the consultation of an ophthalmologists, an otolaryngologist, and an internist, a CT scan of nose, paranasal sinuses, nasolacrimal canal, a video endoscopic study of the nasal cavity. Each patient had indications for surgery. An endonasal dacryocystorhinostomy was performed under the control of video endoscopic technique using the N.V. Volov's Elevator. The surgical approach - via the inferior nasal meatus, under the inferior nasal concha. The surgical method - breaking out of the bone window is performed by turning the elevator medially from the side of the lachrymal sac into the nasal cavity. Results. There were no intraoperative complications. The operation time was less than five minutes. The treatment was carried out on an outpatient basis. During the follow-up period (2-6 months) no relapses were registered. These facts can be regarded as the advantages of this method of surgical treatment of dacryocystitis. Conclusion. The method of endonasal dacryocystorhinostomy, performed through the inferior nasal meatus using an elevator, significantly reduces the time of formation of the bone window and the imposition of the anastomosis between the lachrymal sac and the nasal cavity. The process of intraoperative search for the projection of the nasolacrimal canal simplifies. It also reduces the wound surface and shortens the rehabilitation period.

Radio-wave surgery in the treatment of dacryocystitis

To evaluate the effectiveness of radio-wave surgery in the treatment of dacryocystitis and lacrimal sac abscesses. The clinical group consisted of 207 patients ranging in age from 7 to 89 years (the mean age of 41±7.3 years). For 39% of patients this was a repeated treatment, while 9.3% had undergone 4-5 surgical interventions. The following types of surgical interventions were performed: dacryocystorhinostomy with external approach and lacrimal stent placement - 128, dacryocystectomy for stenosing dacryocystitis with lacrimal stent placement - 21, dacryocystectomy without lacrimal stent placement in somatically complicated patients after repeated dissection of the abscess who developed fistula and granulation - 23, and lacrimal sac abscess drainage - 35. In all patients, the treatment involved high-frequency radio-wave surgery (3.8 to 4 MHz). The article contains a detailed description of the four types of interventions and provides an explanation of the choice of electrode, mode and power level. Positive changes were observed in all cases of chronic dacryocystitis and lacrimal sac abscess. The patency of the lacrimal system, including canalicular and nasolacrimal tests, was assessed 6 months after dacryocystorhinostomy. The results were judged positive in all cases despite slowed dye evacuation in 11 cases. The severity of epiphora (Munk scores) decreased from 3.45±0.7 at baseline to 1.0±0.7 (p<0.05). In 5 dacryocystorhinostomy patients the stoma occluded. Positive characteristics of radio-wave surgery help increase the effectiveness of surgical treatment of dacryocystitis, improve surgical performance, reduce duration of the procedure and postoperative care, reduce the number of complications, and achieve a better cosmetic effect.

Effects analysis of three kinds of operation methods in treatment of dacryocystitis

Effects analysis of three kinds of operation methods in treatment of dacryocystitis

Surgical Treatment of Dacryocystitis

Dacryocystitis is a common infection of the lacrimal sac. In adults, dacryocystitis results from an obstruction (ie, dacryostenosis) of the nasolacrimal duct. Dacryocystitis can be either an acute or chronic infection, and both forms usually are unilateral in nature. The hallmark symptom of both forms of dacryocystitis is epiphora (ie, excessive tearing). An obstruction of the lacrimal duct also can cause dacryocystitis. This article discusses the surgical treatment of dacryocystitis and provides a case study that illustrates perioperative nursing care of a patient who required surgical treatment of this lacrimal duct disorder.

DACRYOCYSTITIS

The problem of dacryocystitis is not one for the ophthalmologist or the rhinologist alone, but for both specialists. The patient's first complaint is that of tearing. This usually brings him to the ophthalmologist. There has been too much dissension over who is the proper authority. It is my opinion that cases of this condition are primarily the ophthalmologist's problem, but certainly a rhinologist who has studied the subject is just as capable of handling them. The region is a sort of no-man's land and has been neglected by both groups of specialists. Since the patient's complaint and the complications (conjunctivitis and corneal ulcer) are concerned with the eye, the problem should primarily be that of the ophthalmologist, but he should consult with the rhinologist in every case and with the internist in special instances. I shall present my concept of the cause and treatment of dacryocystitis, my conclusions having been

XXXVII. Treatment of Dacryocystitis from the Viewpoint of the Rhinologist

XXXVII. Treatment of Dacryocystitis from the Viewpoint of the Rhinologist

Diagnosis and Treatment of Dacryocystitis

<h2>Abstract</h2> Diseases of the lacrimal sac belong to the sphere of the ophthalmologist, who should manage the case, make the diagnosis, decide on the treatment, and accept the assistance of the rhinologist only for the performance of operative technique. Roentgenography of the lacrimal passages, after injection of substances opaque to the x-ray, is painless, and furnishes valuable diagnostic information as to the seat of obstruction if any. The authors have obtained very satisfactory results from the Halle-West operation, the technique of which is carefully discussed in relation to the anatomy of the parts involved.

The Treatment of Dacryocystitis by Curettage. (Thompson): Supplemented by Immediate Rapid Dilatation of the Lacrimonasal Duct

This paper discusses the reasons for using this method of treatment, describes it, reports a series of cases treated by it, and proposes certain instruments for use in such operations.