title: Endoscopic dacryocystorhinostomy with and without silicone intubation: 4 years retrospective study.
abstract: The objective of this study is to assess different outcomes between endoscopic dacryocystorhinostomy (En-DCR) with and without silicone intubation. We retrospectively analyzed 84 patients (89 procedures), suffering from chronic epiphora for primary acquired nasolacrimal duct obstruction, treated with En-DCR and divided into two groups depending on silicone stent intubation. The surgical outcomes were evaluated at 7 post-operative controls using Munk's score criteria. Functional success was defined as absence of epiphora, no further episodes of dacryocystitis, and a patent ostium after fluorescein irrigation. 45 En-DCR with stent and 44 En-DCR without stent were performed. Success rate after 18 months follow-up were, respectively, 82.2 % in the stent group and 88.6 % in the non-stent group (OR 0.59) with no statistical differences. The ostial size reduction has been reported in higher percentage in the stent group, mainly due to peristomal granuloma (OR 3.64), scar tissue formation (OR 2.25), and turbinoseptal synaechia (OR 1.76). The benefits of non-intubation are less patient discomfort, reduced surgical time and costs, simpler follow-up regimen and less intubation-associated complications. En-DCR without silicone stent intubation should be the first choice of procedure, stent intubation should be reserved in selected cases with poor local conditions pre and intra-operatively assessed.
authors.affiliation: Section of Otorhinolaryngology, Head and Neck Surgery, Department of Surgery and Biomedical Science, S.M. della Misericordia Hospital, University of Perugia, Via G. Dottori 1, 06156, Perugia, PG, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Longari
authors.affiliation: Section of Otorhinolaryngology, Head and Neck Surgery, Department of Surgery and Biomedical Science, S.M. della Misericordia Hospital, University of Perugia, Via G. Dottori 1, 06156, Perugia, PG, Italy. dehganipuya@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Dehgani Mobaraki
authors.affiliation: Section of Ophthalmology, Department of Surgery and Biomedical Science, S.M. della Misericordia Hospital, University of Perugia, Perugia, Italy.
authors.forename: A L
authors.initials: AL
authors.lastname: Ricci
authors.affiliation: Section of Otorhinolaryngology, Head and Neck Surgery, Department of Surgery and Biomedical Science, S.M. della Misericordia Hospital, University of Perugia, Via G. Dottori 1, 06156, Perugia, PG, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Lapenna
authors.affiliation: Section of Ophthalmology, Department of Surgery and Biomedical Science, S.M. della Misericordia Hospital, University of Perugia, Perugia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cagini
authors.affiliation: Section of Otorhinolaryngology, Head and Neck Surgery, Department of Surgery and Biomedical Science, S.M. della Misericordia Hospital, University of Perugia, Via G. Dottori 1, 06156, Perugia, PG, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ricci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003607:Dacryocystitis / Q000601:surgery; D003608:Dacryocystorhinostomy / Q000009:adverse effects / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007440:Intubation / Q000379:methods; D007766:Lacrimal Apparatus Diseases / Q000209:etiology / Q000601:surgery*; D007767:Lacrimal Duct Obstruction / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D012828:Silicones / Q000627:therapeutic use*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012828:Silicones
keywords: DCR; DCR without stent; Endoscopic dacryocystorhinostomy; Epiphora; Nasolacrimal duct obstruction