Endoscopic DCR vs. laser-assisted DCR comparative study

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Wasam A Albusalih and Hassanain A Alzubaidy

University of Al-Qadisiyah, Iraq

: J Otol Rhinol

Abstract

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Background: A prospective interventional clinical trial study was conducted for 24 months (from February 2013 to February 2015) at Diwaniya teaching hospital. Subjects: Fifty patients aged 10-62 years with chronic nasolacrimal duct obstruction not resolved by conservative measures. Methods: All the patients received medical treatment and conservative measures for several weeks before starting surgical treatment, then patient divided into two groups: Group 1: treated by endonasal DCR (25 patients). Group 2: treated by endonasal laser-assisted DCR (25 patients). The procedure was performed under general anesthesia for both groups. In both groups bicanalicular silicone stent was used, success of procedure was determined by the absence of epiphora (subjective) and patency of lacrimal system on irrigation (objective). Patients in both groups were under follow up for 7-14 months. Results: Endonasal DCR was done to 25 patients (group 1), and endonasal assisted-DCR for 25 patients (group 2), the average time of procedure in group 1 was 38 minutes, while in group 2 was 25 minutes, the silicone stent was removed 4-6 months after the surgery. Absence of epiphora was in 20 patients out of 25 (80%) in group 1, while it was in 16 patients out of 25 (64%) in group 2 which was significant (P<0.001). Five patients in group 1 developed postoperative adhesion (20%) while in group 2 were 9 patients (36%). All recurrent cases in group 1 due to adhesions, after revision surgery only 2 patients improved raising the success rate to 88%, in group 2 two patients improved after revision surgery raising success rate to 72%. Conclusion: We conclude that endonasal DCR is effective as is endonasal laser-assisted DCR with higher success rate in the former, but with lesser time in the later. Recent Publications 1. Neil Fergie and Nicholas S Jones (2008) Scott- Brown otorhinolaryngology, Head and Neck Surgery. Dacryocystorhinostomy. 133: 1689-98. 2. Daniel Simmen and Nick Jones (2005) Manual of Endoscopic Sinus Surgery. Dacryocystorhinostomy technique 14:194-2. 3. Peerooz Saeed, Zachary M. Soler, Christos Georgalas and Ralph Metson (2013) Rhinology and Skull Base Surgery. Into and around the orbit, Endoscopic DCR 37:713-19. 4. Roy R Casiano , Islam R Herzallah, Amy S Anstead, Jean Anderson Eloy, Adam Folbe, Lori Lemonnier and Belachew Tessema (2012) Endoscopic Sinonasal Dissection Guide. Basic Endoscopic Sinonasal Dissection, Inferior turbinoplasty and submucous Resection of the inferior turbinate 5:23-25. 5. Warner Hosemann and Jochen Fanghanel (2005) A Dissection Course on Endoscopic Endonasal Sinus Surgery. Inferior Turbinoplasty. 8.12:33.

Biography

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Wasam A Albusalih has completed his Graduation at College of Medicine, Baghdad in 1999, Degreed in Otorhinolaryngology Head and Neck Surgery in 2013. His research interest is in endoscopic sinus surgery and he did more than 100 successful DCR and about 500 endoscopic sinus operations with few endoscopic skull base operations in last 3 years at Diwaniya, Iraq.

E-mail: Wasamalbusalih@gmail.com