J Korean Ophthalmol Soc.  2018 Apr;59(4):307-313. 10.3341/jkos.2018.59.4.307.

The Clinical Effects of Triamcinolone-soaked Nasal Packing on Endonasal Dacryocystorhinostomy

• Song SH
• Lee KH

• KMID: 2409677
• DOI: http://doi.org/10.3341/jkos.2018.59.4.307

Abstract

PURPOSE
To evaluate the clinical effects of triamcinolone-soaked nasal packing on endonasal dacryocystorhinostomy (DCR).
METHODS
The study included 91 patients (156 eyes) with primary acquired nasolacrimal duct obstruction who underwent endonasal DCR from March 2015 to February 2017. A total of 50 eyes were packed with triamcinolone-soaked Nasopore® and 106 eyes were packed with Nasopore® without triamcinolone (control group). The anatomical and functional success percentage, revision percentage, and postoperative complications such as granulation, synechiae, and membrane formation were compared between the groups at 1 week, 1 month, 2 months, and 4 months postoperatively.
RESULTS
At postoperative 2 months, there was a statistically significant difference in the anatomical success percentage in the triamcinolone-soaked group (100%) compared to the control group (86.8%; p = 0.007). There were no statistically significant differences between the two groups in anatomical success percentage at postoperative 4 months (p > 0.05). However, there was a statistically significant difference in the functional success percentage in the triamcinolone-soaked group (92.0%) compared to the control group (78.3%; p = 0.035). When comparing postoperative complications, the triamcinolone-soaked group (4.0%) had a lower incidence of granulation than the control group (16.0%) (p = 0.032), but there were no differences in synechiae and membrane formation (p > 0.05). There was a statistically significant difference in the revision percentage in the triamcinolone-soaked group (4.0%) compared to the control group (16.0%) (p = 0.032).
CONCLUSIONS
Triamcinolone-soaked nasal packing for endonasal DCR is an effective method for increasing the success percentage and lowering the incidence of granuloma and revision percentages.

Keyword

Endonasal dacryocystorhinostomy; Nasopore; Triamcinolone

MeSH Terms

Dacryocystorhinostomy*
Granuloma
Humans
Incidence
Membranes
Methods
Nasolacrimal Duct
Postoperative Complications
Triamcinolone
Triamcinolone

Figure

• 

  Figure 1. Endoscopic view of one patient. Endoscopic appearance of the middle meatus (A) before endonasal dacryocystorhinostomy, (B) after endonasal dacryocystorhinostomy with triamcinolone-soaked Nasopore® packing.

• 

  Figure 2. Comparison of the anatomical success percentage between the two groups over time. At postoperative 2 months, there was a statistically significant difference in the anatomical success percentage in the triamcinolone-soaked group compared to the control group (p = 0.007). There were no statistically significant differences between the two groups in anatomical success percentage at postoperative 4 months (p > 0.05).

• 

  Figure 3. Comparison of the functional success percentage between the two groups over time. At postoperative 4 months, there was a statistically significant difference in the functional success percentage between the two groups (p = 0.035).

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