Contributing factors to prevent prolonged epiphora after maxillectomy.
OBJECTIVE
To analyze the incidence of prolonged epiphora after maxillectomy according to transected nasolacrimal duct management technique, type of tumor, radiotherapy, and timing of tube removal and performance of dacryocystorhinotomy.


METHODS
Retrospective medical record review. Settings University hospitals.


METHODS
We studied 89 patients (90 cases) who underwent nasolacrimal duct transection during maxillectomy with preservation of orbital contents for the management of sinonasal tumors between July 1, 1996, and January 31, 2008.


METHODS
The incidence of prolonged epiphora was analyzed according to 4 different transected nasolacrimal duct management techniques: simple transection without any additional procedure, silicone tube stenting, transcanalicular Silastic stenting, and marsupialization without stenting. We also analyzed the relationship between other factors (type of tumor, radiotherapy, and timing of tube removal) and the incidence of prolonged epiphora. Prolonged epiphora was defined as persistent if it lasted longer than 6 months.


RESULTS
The overall incidence of prolonged epiphora was 15.6% (14 of 90 cases). The prolonged epiphora rates differed according to the management technique (no procedure, 27.3% [3 of 11 cases]; silicone tube, 7.0% [4 of 57 cases]; transcanalicular Silastic stenting, 66.7% [4 of 6 cases]; marsupialization, 18.8% [3 of 16 cases]; P = .002). The silicone tube technique showed the lowest rate (odds ratio = 0.20, P = .06). In contrast, the incidence of prolonged epiphora was not affected by the type of tumor, postoperative radiotherapy, or timing of tube removal.


CONCLUSIONS
Silicone tube stenting can be used as the effective and convenient transected nasolacrimal duct reconstructive technique to prevent prolonged epiphora.
Department of Otolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Seoul, South Korea.
Nam-Kyung
NK
Yeo
Jong Hwan
JH
Wang
Yoo-Sam
YS
Chung
Yong Ju
YJ
Jang
Bong-Jae
BJ
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018322:Angiofibroma / Q000601:surgery; D002277:Carcinoma / Q000601:surgery; D005260:Female; D018214:Fibroma, Ossifying / Q000601:surgery; D005870:Giant Cell Tumors / Q000601:surgery; D006391:Hemangioma / Q000601:surgery; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery; D007766:Lacrimal Apparatus Diseases / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008444:Maxillary Sinus Neoplasms / Q000601:surgery*; D008545:Melanoma / Q000601:surgery; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery*; D018308:Papilloma, Inverted / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery; D012828:Silicones; D015607:Stents
D012828:Silicones