title: Symptom score questionnaire for nasolacrimal duct obstruction in adults--a novel tool to assess the outcome after endoscopic dacryocystorhinostomy.
abstract: BACKGROUND
  The incidence of nasolacrimal pathway obstruction increases with age, and dacryocystorhinostomy (DCR) is a commonly applied surgical technique to treat severe cases. However, no disease-specific tools to assess the symptoms and the subjective outcome after DCR have been established. We have developed a specific Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS) questionnaire to evaluate the outcome, and tested it in a prospective clinical trial.
  
  
  METHODS
  Prospective clinical follow-up study.
  
  
  METHODS
  Sixty-eight consecutive primary endoscopic dacryocystorhinostomy (EN-DCR) procedures were performed in 64 patients during 2004-2008. Preoperatively and during the three follow-up visits (at 1 week, 2 and 6 months), the patients filled in the NLDO-SS, and at the second and third follow-up visits they also filled in the Glasgow Benefit Inventory (GBI) questionnaire. At one year after the operation, a GBI questionnaire was sent to the patients.
  
  
  RESULTS
  The surgical success rate of EN-DCR was 93 %. EN-DCR resulted in a significant reduction in all of the eight symptoms scores of the NLDO-SS (p= 0.001). The GBI scores indicated a significant benefit at 2 months (+37 (SD; 28) and an even higher benefit at 6 months after surgery (+52 (SD; 29), p= 0.001), but no further improvement was found between 6 and 12 months (+52 vs +52, p= 1.0). The correlation between the total GBI and NLDO-SS was significant (p=0.001).
  
  
  CONCLUSIONS
  EN-DCR significantly improves the quality of life as measured by the GBI. The NLDO-SS correlated with the GBI and gave more information about the benefits after EN-DCR than GBI alone. The NLDO-SS proved to be an effective tool to evaluate lacrimal obstructions and EN-DCR benefits. Further studies to validate NLDO-SS are needed.
authors: Department of Otorhinolaryngology, Institute of Clinical Medicine, Kuopio University Hospital, and University of Eastern Finland, Finland.
authors: Grigori
authors: G
authors: Smirnov
authors: Henri
authors: H
authors: Tuomilehto
authors: Hannu
authors: H
authors: Kokki
authors: Tatu
authors: T
authors: Kemppainen
authors: Vesa
authors: V
authors: Kiviniemi
authors: Juhani
authors: J
authors: Nuutinen
authors: Kai
authors: K
authors: Kaarniranta
authors: Juha
authors: J
authors: Seppa
mesh_terms: D000367:Age Factors; D000368:Aged; D003608:Dacryocystorhinostomy; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000592:standards*; D009301:Nasolacrimal Duct / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D059035:Perioperative Period / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome