Correlation of orbital computed tomographic findings with office probing and irrigation in 17 patients after successful and failed dacryocystorhinostomy.
OBJECTIVE
To investigate the role of orbital computed tomography (CT) in the evaluation of patients after dacryocystorhinostomy (DCR).


METHODS
Computed tomography scans of patients who underwent both successful and failed DCR were examined to determine the relationship of the soft-tissue changes to the surgical ostium, and the findings were correlated with postoperative results of office probing and irrigation.


RESULTS
After a successful DCR (n = 7), a patent fistulous tract was confirmed by office probing and irrigation. A characteristic "Y-on-its-side" configuration of the soft tissue was noted on a CT scan. Total occlusion of the osteotomy by soft tissue on probing and irrigation corresponded to a mucocelelike soft-tissue density with a central lucency and soft-tissue obstruction (n = 2). Total occlusion of the osteotomy by inadequate excision of bone and adjacent soft tissue, visualized by CT imaging, was confirmed by palpation of bone by office probing (n = 1). Partial obstruction on probing and irrigation was associated on a CT scan with an increased soft-tissue density (n = 4) and bone in the region of the osteotomy (n = 3).


CONCLUSIONS
Computed tomography allows visualization of a patent fistula after successful DCR as well as soft-tissue or bone obstruction of the surgically created fistula after failed DCR. When combined with probing and irrigation, CT helps to formulate a surgical plan after failed DCR.
Mauriello
J A
JA
Department of Ophthalmology, UMD-New Jersey Medical School, Newark, USA.
Vahedra
V
V
Fleckner
M
M
Shah
C
C
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003608:Dacryocystorhinostomy; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000000981:diagnostic imaging; D009915:Orbit / Q000000981:diagnostic imaging*; D010045:Outpatients; D007507:Therapeutic Irrigation / Q000379:methods*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids