title: Long-term outcomes of endoscopic endonasal conjunctivodacryocystorhinostomy with Jones tube placement: a thirteen-year experience.
abstract: OBJECTIVE
  To report thirteen years of experience with endoscopic-assisted endonasal primary conjunctivodacryocystorhinostomy (CDCR) and revision with Jones tube placement in Korean patients.
  
  
  METHODS
  Thirty-three patients who underwent primary endoscopic endonasal CDCR with a Jones tube and were followed for over 6 months and 22 patients who underwent revision CDCR were retrospectively reviewed. We evaluated the cause of obstruction, operation time, tube length, success rate (at 6, 12 and 24 months), and the cause of failure for primary and revision procedures.
  
  
  RESULTS
  The most common cause for operation in primary CDCR was trauma. The mean operation time was 26 min and 24 min in the primary and revision groups. The initial success rate was 87.9% vs. 74.3% at 6 months postoperative and 63.6% vs. 60% at two years after surgery in the primary and revision group. The most common reason for failure in both groups was medial migration of the tube, and the mean onset of these complications was about 10 months postoperative. Other major reasons for failure were inappropriate length of tube insertion in the primary group and inflammation in the revision group.
  
  
  CONCLUSIONS
  Fatal complications which lead to failure may develop many months into the procedure, so long-term follow-up is necessary. The most common cause of failure was medial migration of the Jones tube; however, inappropriate tube insertion in primary surgery and severe inflammation in revision may also be concerns.
authors.affiliation: Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
authors.forename: Minwook
authors.initials: M
authors.lastname: Chang
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hwa
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, KEPCO Medical Center, Seoul, Republic of Korea.
authors.forename: Minsoo
authors.initials: M
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: shbaek6534@korea.ac.kr.
authors.forename: Sehyun
authors.initials: S
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D000069282:Canaliculitis / Q000209:etiology; D003228:Conjunctiva / Q000601:surgery; D003430:Cross-Sectional Studies; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D007440:Intubation / Q000295:instrumentation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000293:injuries / Q000601:surgery; D061646:Operative Time; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cause of failure; Endoscopic endonasal CDCR; Length of Jones tube; Operation time; Primary and revisional surgery; Success rate