The Relationship between Rate of Wound Healing and Success Rate after Endonasal Laser-drill Assisted Dacryocystorhinostomy

Lee, T S; Kim, S W; Park, B W

Abstract

The success of endonasal dacryocystorhinostomy mainly depends on how clearly the wound of internal ostium is healed. So we periodically followed the patients with nasal endoscope to search for the possible complications during the wound healing period and assessed the relationship between rate of wound healing and success rate. Fifty eyes of fifty patients who could have been followed more than 5 months were included in this retrospective study. We performed endonasal dacryocystorhinostomy with nasal endoscope, YAG laser, and micro-drill. 0.2 mg/ml[0.02%] mitomycin C was instilled topically twice daily for the first 7 days immediately after surgery and for 7 days 4 weeks after surgery, respectively. After surgery, we observed wound healing process and complications with nasal endoscope. The wound healing of the internal ostium was completed between 4 and 15 weeks[mean: 7.4 weeks]. Most common postoperative complications were granuloma and inflammation. Membranous obstruction and synechia were also observed. We thought that the wound healing was delayed due to the use of mitomycin C. However, no local infection and systemic complication occured with use of mitomycin C. The patients with delayed wound healing experienced more granulomas and inflammations than those with early wound healing, but there was no relationship between the wound healing rate and the success rate. We concluded that minimizing the damage of tissue of nasal cavity is essential to increase the success rate of the surgery and the use of topical mitomycin C as an adjunctive therapy can decrease formation of granuloma and increase the patency of internal ostium and the success rate.