J Korean Ophthalmol Soc.  2013 Jan;54(1):7-11. 10.3341/jkos.2013.54.1.7.

The Effect of Dacryocystorhinostomy and Septoplasty Combination Surgery for Lacrimal Obstruction with Septal Deviation

• Kim AR
• Choi CW
• Kim SD

• KMID: 2216442
• DOI: http://doi.org/10.3341/jkos.2013.54.1.7

Abstract

PURPOSE
To evaluate the clinical effect of endonasal dacryocystorhinostomy (DCR) and septoplasty combination surgery for lacrimal obstruction in patients with nasal septal deviation.
METHODS
The study group consisted of 24 eyes of 24 lacrimal obstruction patients with nasal septal deviation who had undergone endonasal DCR combined with septoplasty from 2006 to 2012. The types of lacrimal obstruction included nasolacrimal duct obstruction (18 cases), common canaliculus obstruction (5 cases) and lower lacrimal duct obstruction (1 case). The operations' procedure was as follows: first, an otorhinolaryngologist performed septoplasty and then, an ophthalmologist performed endonasal DCR. For catamnesis observation after the surgery, the operations' results and nasal complications were retrospectively analyzed.
RESULTS
A total of 24 eyes of 24 patients were included in the present study. Eight patients were males, 16 patients were females and the mean patient age was 52.1 years. During 15.5 months of catamnesis, loss of epiphora was observed in 20 cases, improvement in epiphora was found in 3 cases, and the functional and anatomical success rate was 95.8% (23/24). Eight cases of postoperative complication were observed, 7 cases of granuloma were found in the bony ostium and surrounding area, and 1 case of synechia was found in the nasal cavity.
CONCLUSIONS
The combination surgery of endonasal DCR and septoplasty provides a wider surgical view, allowing for an easier nasal cavity treatment, rendering the operation and after-care less difficult, as well as reducing the risk of surrounding tissue damage. This method is adequate for preventing complications after surgery and offers a better prognosis.

Keyword

Endonasal dacryocystorhinostomy; Septal deviation; Septoplasty

MeSH Terms

Dacryocystorhinostomy*
Female
Granuloma
Humans
Lacrimal Apparatus Diseases
Lacrimal Duct Obstruction
Male
Nasal Cavity
Nasolacrimal Duct
Postoperative Complications
Prognosis
Retrospective Studies

Figure

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  Figure 1. Preoperative, intraoperative and postoperative findings of the left nasal cavity. (A) Preoperative image shows the narrow nasal cavity. (Black arrow head: deviated septum) (B) Postoperative image shows enough widening nasal cavity to see the inner structure. (C) This image shows the nasal ostium and silicone tubes. (Black arrow head: bony ostium)

• 

  Figure 2. Postoperative nasal complications. (A) This image shows a small granuloma (arrow) around bony ostium. (B) This image shows mild synechiae (arrow) in nasal cavity.

Reference

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