title: The efficacy of sleeve technique in primary nasolacrimal duct obstruction with a high lacrimal sac.
abstract: OBJECTIVE
  To evaluate the efficacy of a sleeve technique during endoscopic dacryocystorhinostomy (DCR) in primary nasolacrimal duct obstruction (NLDO) patients with a high lacrimal sac.
  
  
  METHODS
  The medical records of 45 patients (49 cases) undergoing endoscopic DCR for primary NLDO with a high lacrimal sac were retrospectively reviewed. In 19 patients (21 cases), the thick maxilla covering the common canalicular opening was removed using a drill and a bicanalicular silicone tube was inserted (group 1). In 26 patients (28 cases), instead of removal of the thick maxilla, a sleeve was inserted into the bicanalicular silicone tube (group 2). At 6 months postoperatively, the success rate was evaluated and the size of the intranasal mucosal ostium was measured.
  
  
  RESULTS
  The success rates in group 1 and 2 was 90.5% and 96.4%, respectively (P = 0.400). The intranasal mucosal ostium in group 1 and 2 measured 1.7 ± 0.7 mm and 3.1 ± 1.0 mm, respectively, and the difference was significant (P = 0.042).
  
  
  CONCLUSIONS
  In primary NLDO patients with a high lacrimal sac, DCR inserting a silicone tube and a sleeve together had a satisfactory success rate without using a drill. In comparison with traditional surgical methods, it helped enlarge the size of the intranasal mucosal ostium.
authors.forename: Kyoung-Nam
authors.initials: KN
authors.lastname: Kim
authors.forename: Yeon-Hee
authors.initials: YH
authors.lastname: Lee
authors.forename: Jung-Yeul
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
authors.forename: Sung-Bok
authors.initials: SB
authors.lastname: Lee
mesh_terms: D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D012826:Silicone Elastomers; D016896:Treatment Outcome
chemical_list: D012826:Silicone Elastomers