• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권4호
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• pp.322-326
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• 1992

Epiphora is overflow of tears due to obstruction of lacrimal duct. Dacryocystorhinostomy is the most common procedure to eliminate the epiphora secondary to complete or partial obstruction of the nasolacrimal duct. The procedure is to artificially create passage between lacrimal sac and nasal cavity. Especially, epiphora would be accompany often by nasolacrimal duct obstruction when trauma of oromaxillofacial area lead to nasal fracture, medial wall fracture of orbit. Therefore in this case there are many case to perform dacryocystorhinostomy because probing and tubing is difficult to resolve the epiphora. We performed 4 cases of dacryocystorhinostomy for adult nasolacrimal duct obstruction from May 1991 to October 1991. The results were very satisfactory in all the case. Epipora disappeared in all case.

• 대한기관식도과학회지
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• 제4권2호
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• pp.188-192
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• 1998

Background and Objectives： The most common cause of the failure of endoscopic dacryocystorhinostomy is closure of the osteotomy site due to granulation or adhesion. We used mitomycin-C, an antineoplastic antibiotic agent, soaking over the osteotomy site to suppress fibrous proliferation and scar formation during the endoscopic dacryocystorhinostomy. Materials and Methods : A total of 20 Patients diagnosed with nasolacrimal duct obstruction were assigned randomly to either a mitomycin-C group or a control group. Endoscopic dacryocystochinostnmy has been used in both groups. In the mitomycin-C group, a piece of merocel soaked with 0.2 mg/ml mitomycin-C was applied to the osteotomy site and then after 30 minutes was removed. Results : All patients in the mitomycin-C group remained symptom free after removal of their silicone tube (100% success), and there were two patients in the control group who had recurrent epiphora (67% success). In the mitomycin-C group, the average surface area of the osteotomy at the end of the sixth postoperative month was 4.1 $\textrm{mm}^2$, whereas that of the control group was 2.5 $\textrm{mm}^2$. Neither serious systemic nor local toxicity were noted in the mitomycin-C group. Conclusion : Intraoperative mitomycin-C may possibly improve success rates over the endoscopic dacryocystorhinostomy procedure.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.239-245
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• 1994

When the midfacial fractures involve the upper maxilla (LeFort I, II, III), there is a chance that the nasolacrimal duck may have been injured. When this suspected, We must observe the presence of epiphora carefully. If the epiphora was not improved following conservative treatment, dacryocystorhinostomy would be the treatment of choice. We performed two cases of DCR and got the favorable results.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.358-368
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• 2018

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

• Korean Journal of Ophthalmology
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• 제32권6호
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• pp.433-437
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• 2018

Purpose: Various absorbable anti-adhesion agents have been used to prevent postoperative synechia formation after endonasal surgery. The purpose of this study was to evaluate the anti-adhesion effects of HyFence and Mediclore after endonasal dacryocystorhinostomy (DCR) compared to a mixed solution of hyaluronic acid and sodium carboxymethylcellulose (Guardix-Sol). Methods: In this retrospective study, endonasal DCR and silicone tube intubation were performed on 198 eyes of 151 patients. Three different anti-adhesion adjuvants were applied to the osteotomy site in the nasal cavity after standard endonasal DCR procedures. The subjects were classified into three respective groups: group A (71 eyes, Guardix-Sol 1.5 g), group B (89 eyes, HyFence 1.5 mL), and group C (38 eyes, Mediclore 1 cc). The three groups were evaluated by asking patients about subjective symptoms and by performing lacrimal irrigation tests and endoscopic examinations. Results: There were no statistically significant differences in age, sex, timing of tube removal, or follow-up period among the three groups. There were no statistically significant differences in success rates among the three groups (p = 0.990, 91.5% [65 / 71], 92.1% [82 / 89], and 92.1% [35 / 38], respectively). Conclusions: HyFence and Mediclore are safe and effective adjunctive modalities following endonasal DCR compared to Guardix-Sol. Therefore, these agents can be considered good alternatives to Guardix-Sol to increase the success rate of endonasal DCR in treating patients with poor prognosis.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.32-37
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• 2011

Purpose: Canalicular laceration is relatively common due to its exposed, vulnerable location in case of facial trauma. Conjunctivodacryocystorhinostomy has been the standard treatment for canalicular obstruction secondary to unrepaired canalicular laceration. In spite of a high rate of relieving tear-duct obstruction, this method is noted to be associated with low rate of patient satisfaction and a number of complications. The goal of this study is to report the good results of delayed lacrimal stent implantation with Mini Monoka$^{(R)}$ for patients whose canaliculi were not repaired by initial surgery. Methods: From May of 2005 to February of 2007, four patients who underwent delayed lacrimal stent implantation using Mini Monoka$^{(R)}$ in canalicular laceration were retrospectively reviewed. First, the previous scar incision was made over the lower lid and we identified the cut end of proximal lacerated canaliculus. The Mini Monoka$^{(R)}$ was passed through the punctum to the cut end of the proximal lacerated canaliculus. We identified the cut end of the distal lacerated canaliculus, whose cut end has rolled white edges after careful excision of the scarred lid tissue. We then passed Mini Monoka$^{(R)}$ through the lacerated inferior canaliculus. Using an operating microscope, we placed three interrupted sutures of 8-0 Ethilon to join the canalicular ends. Silicone stent was left in place for 6 months. The mean age of the patients was 48.5 years (range, 35 to 59 years). The time interval from initial trauma to delayed lacrimal stent implantation was between 3 and 31 days. Follow-up periods ranged from 12 and 20 months. Results: The results of reconstruction were classified into normal, fair and poor. Patent lacrimal drainage systems were achieved in three of the four cases. In one case, epiphora was encountered. No cases of stent displacement, conjunctivitis or granuloma formation were encountered. Conclusion: Even though canalicular reconstruction was delayed for a long time, attempting canalicular reconstruction would be acceptable before considering secondary operations like dacryocystorhinostomy and conjunctivodacryocystorhinostomy.

• 대한안과학회지
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• 제55권1호
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• pp.1-6
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• 2014

목적: 갑상선암에서 방사성 요오드 치료 후 발생한 코눈물길 폐쇄의 임상양상에 대해 알아보고자 하였다. 대상과 방법: 2009년 1월부터 2011년 12월까지 갑상선암 수술 후 방사성 요오드 치료를 받은 환자 총 622명 중 눈물흘림 증상으로 성형안과에서 관류검사, 더듬자 검사 및 눈물주머니 조영술을 통해 코눈물길 폐쇄를 진단 받은 14명(18안)을 대상으로 하였다. 대상환자의 방사성 요오드 치료량과 횟수, 코눈물길 폐쇄의 임상양상, 치료법을 의무기록을 후향적으로 분석하여 확인하였다. 결과: 코눈물길 폐쇄가 진단된 환자 14명은 코눈물길 폐쇄가 발생하지 않은 환자군에 비해 평균 치료 용량($215.7{\pm}23.1mCi$, p=0.01)과 치료횟수($1.36{\pm}0.50$회, p<0.001)가 유의하게 높았다. 눈물흘림 증상 발생까지 평균 10.2개월, 진단까지 평균 18.4개월이 걸렸다. 14명(18안) 중 공통눈물소관폐쇄는 3명(3안), 코눈물관폐쇄는 11명(15안)이었다. 10명(13안)은 눈물길의 완전폐쇄가 확인되어 내시경하눈물주머니 코안연결술을 시행 받았으며, 4명(5안)은 부분폐쇄를 보여 내시경하 실리콘 관을 삽입하였다. 결론: 갑상선암에서 방사성 요오드 치료 후 코눈물길 폐쇄가 드물게 발생할 수 있다. 방사성 요오드 치료 후 눈물흘림 증상을 호소하는 환자가 있을 경우 합병증으로 코눈물길 폐쇄가 발생할 수 있음을 인지하고, 초기에 성형안과에 의뢰하여 전문적인 평가 및 치료가 시행되어야 한다.