J Korean Ophthalmol Soc.  2017 May;58(5):586-590. 10.3341/jkos.2017.58.5.586.

Effects of Triamcinolone-soaked Packing for Endonasal Revision in Patients with Failed Endoscopic Dacryocystorhinostomy

• Jung YH
• Lee KH

• KMID: 2378630
• DOI: http://doi.org/10.3341/jkos.2017.58.5.586

Abstract

PURPOSE
To evaluate the efficacy of endonasal revision using triamcinolone-soaked nasal packing in patients exhibiting recurrence of epiphora after endoscopic dacryocystorhinostomy.
CASE SUMMARY
Four patients (4 eyes) who presented with the chief complaint of recurrence of epiphora after endoscopic dacryocystorhinostomy underwent endonasal revision under local anesthesia. On nasal endoscopy, granulation tissue and membranous tissue around the osseous foramen was removed during endonasal revision. According to the operator's judgement, the osseous foramen was additionally expanded. Following insertion of a silicone tube, triamcinolone-soaked nasal packing was used for intra-nasal packing. The silicone tube was removed after follow-up of more than 12 weeks. Immediately after removing the silicone tube, there was free passage of saline on lacrimal syringing as well as complete resolution of epiphora. At over 6 months of follow-up after tube removal, there was no recurrence of epiphora in any of the 4 patients.
CONCLUSIONS
Triamcinolone-soaked nasal packing may be considered in patients with failed endoscopic dacryocystorhinostomy.

Keyword

Endonasal revision; Endoscopic dacryocystorhinostomy; Nasopore; Triamcinolone

MeSH Terms

Anesthesia, Local
Dacryocystorhinostomy*
Endoscopy
Follow-Up Studies
Granulation Tissue
Humans
Lacrimal Apparatus Diseases
Recurrence
Silicon
Silicones
Triamcinolone
Silicon
Silicones
Triamcinolone

Figure

• 

  Figure 1 Endoscopic view of case 1. (A) Granulomatous obstruction of bony opening at 2 months after endonasal dacryocystorhinostomy (arrow). (B) After 2 weeks of removal of granulomatous tissue and silicone tube insertion using triamcinolone-soaked synthetic sponge (Nasopore®). (C) Patent bony opening at 6 months after tube removal.

• 

  Figure 2 Endoscopic view of case 4. (A) Membranous obstruction of bony opening at 3 months after endonasal dacryocystorhinostomy (arrow). (B) After removal of membranous tissue, silicone tube insertion and triamcinolone-soaked synthetic sponge (Nasopore®) was used for the intra-nasal packing. (C) Patent bony opening at 6 months after tube removal.

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