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Endoskopik dakriyosistorinostomide çekiç-keski tekniği

HAMMER CHIESEL TECHNIQUE IN ENDOSCOPIC DACRYOCYSTORHINOSTOMY

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Background: Endoscopic dacryocystorhinostomy (DCR) gained wide acceptance, with a comperable success to external DCR. Removal of sufficient bone over the lacrimal sac in endoscopic DCR is crucial in obtaining a permanent rhinostoma. Several different methods utilized to accomplish this goal. Aims: To describe the technique using hammer-chisel endoscopically for removal of bone over the lacrimal sac. Advantages and shortcomings of this technique were discussed in the light of literature. Methods: Prospective evaluation of endoscopic hammer-chisel DCR performed on 56 eyes of 40 patients with chronic epiphora or dacryocystitis were evaluated (24 unilateral and 16 bilateral, 36 female and 4 male). Hammer-chiesel endoscopic DCR technique included chiesel removal of the bone located over the lacrimal sac. Preoperative intra or postoperative findings and follow-up rewieved and discussed. Results: Follow-up period was 6 to 48 months (mean, 22) postoperatively. Success rate of consecutive endoscopic hammer-chisel DCR was 87.7%. Intraoperatively, 8 cases showing mild mucosal haemorrhage which neither prevented a successful completion of operation. Excellent patient tolerance with minimal morbidity and no major complication was observed. Conclusions: Endoscopic Hammer-chisel DCR is less traumatic and practical with minimal per and postoperative complications. It requires minimal instrumentation and is an easy and fast technique.
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Abstract (Original Language): 
Giriş: Endoskopik dakriyosistorinostomi (DSR) son zamanlarda eksternal DSR başarı oranlarına yaklaşan bir başarı oranı ile geniş bir kabul gördü. Endoskopik DSR'de kalıcı bir açıklık elde edilebilmesi için lakrimal kese üzerindeki kemiğin yeterince uzaklaştırılması önemlidir.Değişik birkaç metot bu amaç için kullanılmıştır. Amaç: Lakrimal kese üzerindeki kemiği uzaklaştırmak için çekiç-keski metodunu kullanan tekniği tanımlamaktır. Bu tekniğin avantaj ve dezavantajları literatür ışığında tartışıldı. Metot: Kronik epifora ya da dakriyosistitli 40 hastanın 56 gözüne (24 unilateral ve 16 vaka bilateral, 36 kadın ve 4 erkek) uygulanan endoskopik çekiç-keski DSR prospektif olarak değerlendirildi. Çekiç-keski endoskopik DSR tekniği lakrimal kese üzerindeki kemiğin keski ve çekiç kullanılarak uzaklaştırılmasını içermektedir. Preoperatif, inta ve postoperatif bulgular değerlendirildi ve karşılaştırıldı. Bulgular: Postoperatif takip süresi 6 ile 48 ay idi (ortalama, 22 ay). Ardışık endoskopik çekiç-keski DSR'nin başarı oranı %87.7 idi. İntraoperatif olarak 8 vakada hafif mukozal hemoraji gözlendi ancak hiçbiri operasyonun başarı ile tamamlanmasını engellemedi. Minimal morbidite ile birlikte mükemmel bir hasta kompliansı mevcuttu ve majör hiçbir komplikasyon gözlenmedi. Sonuç: Endoskopik çekiç-keski DSR minimal intra ve postoperatif komplikasyonu yanısıra daha az travmatik ve pratik bir yöntemdir. Minimal teçhizatlanma gerektirir, kolay ve hızlı bir tekniktir.
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  • 1
19-23
  • Turkish

REFERENCES

References: 

1. Caldwell GW. A new operation for the radical cure of obstruction of the nasal duct. N Y Med 1893;58:476.
2. West JM. A window resection of the nasal duct in cases of stenosis. Trans Am Ophtalmol Soc 1914;12:654.
3. Björk H. Endonasal surgery of the lacrimal passages: Dacryocystorhinostomy and canaliculorhinostomy with intubation. Acta
Otolaryngol (Stockh) 1966;27:161.
4. Jokinen K, Karja J. Endonasal Dacryocystorhinostomy. Arch Otolaryngol 1974;100:41-4.
5. Steadman MG. Transnasal dacryocystorhinostomy. Otolaryngol Clin North
Am 1985;18:107-11.
6. Rice DH. Endoscopic intranasal dacryocystorhinostomy: results in four patients. Arch Otolaryngol Head Neck Surg 1990;116:1061-5.
7. Massaro BM, Gonnering RS, Harris GJ. Endonasal laser dacryocystorhinostomy: a new approach to nasolacrimal duct obstruction.
Arch Ophthalmol 1990;108:1172-6.
8. Metson R. Endoscopic surgery for lacrimal obstruction. Otolaryng Head
Neck 1991;104:473-9.
9. Gonnering RS, Lyon BD, Fisher CJ. Endoscopic laser-assisted dacryocystorhinostomy. Am J Ophthalmol 1991;111:152-7.
10. Bartley GB. Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Ophthal Plast Reconstr Surg 1992;8:237-49.
11. Mannor GE, Millman AL. The prognostic value of preoperative dacryocystography in endoscopic intranasal dacryocystorhinostomy. Am J
Ophthalmol 1992;113:134-7.
12. Woog JJ, Metson R, Puliafito CA. Holmium YAG endonasal laser dacryocysto-rhinostomy. Am J Ophthalmol 1993;116:1-10.
13. Whittet HB, Andrien Shun-Shin G, Awdry P. Functional endoscopic transnasal dacryocystorhinostomy. Eye 1993;7:545-9.
14. Metson R, Woog JJ, Puliafito CA. Endoscopic laser dacryocystorhinostomy. Laryngoscope 1994;104:269-74.
15. Boush GA, Bradley NL, Dortzbach RK. Results of endonasal laser-assisted dacryocystorhinostomy. Ophthalmology 1994;101:955-9.
16. Kong YT, Kim TI, Byung WK. A report of 131 cases of endoscopic laser lacrimal surgery. Ophthalmology 1994;101:1793-800.
17. Mickelson SA, Kim DA,Stein IM. Endoscopic laser-assisted dacryocystorhinostomy. Am J Otolaryngol. 1997;18:107-11.
18. Hausler R, Caversaccio M. Microsurgical endonasal dacryocystorhinostomy with long term insertions of bicanalicular silicone tubes. Arch Otolaryng
Head Neck 1998;124:188-91.
19. Cunnigham MJ, Woog JJ. Endonasal Endoscopic Dacryocystorhinostomy in children. Arch Otolaryng Head Neck 1998;124:328-33.
20. Christenbury JD. Translacrimal laser dacryocystorhinostomy. Arch
Ophthalmol 1992;110:170-1.
21. Levin PS, Stormogipson DJ. Endocanalicular laser-assisted dacryocystorhinostomy: an anatomic study. Arch Ophthalmol
1992;110:1488-90.
22. Lee JM, Song HM, Han YM, et al. Balloon dacryocystoplasty: results in the treatment of complete and partial obstructions of the nasolacrimal system.
Radiology 1994;192:503-8.
23. Perry JD, Maus M, Novinski TS, Penne RB. Balloon catheter dilatation for treatment of adults with partial nasolacrimal duct obstruction: a preliminary report. Am J Ophthalmol 1998;126:811-6
24. Rebeiz EE, Shapshay SM, Bowlds JH, Pankratov MM. Anatomic guidelines for dacryocystorhinostomy. Laryngoscope 1992:102;1181-4.
25. Osguthorpe JD, Hoang G. Nasolacrimal injuries: evaluation and management. Otolaryngol Clin North Am 1991;24:59-78.
26. Welham RA. Management of unsuccessful lacrimal surgery. Br J
Ophthalmol 1987;71:152-7.
27. Becker BB. Dacryocystorhinostomy without flaps. Ophthalmic Surg
1988;19:419-27.

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