Dr. Wormald receives royalties from Medtronic for design of instruments and is a consultant for Neilmed. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Powered endoscopic dacryocystorhinostomy with selective stenting†
Article first published online: 18 JUN 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 7, pages 1449–1452, July 2010
How to Cite
Callejas, C. A., Tewfik, M. A. and Wormald, P.-J. (2010), Powered endoscopic dacryocystorhinostomy with selective stenting. The Laryngoscope, 120: 1449–1452. doi: 10.1002/lary.20916
- Issue published online: 25 JUN 2010
- Article first published online: 18 JUN 2010
- Manuscript Accepted: 2 MAR 2010
- Manuscript Revised: 23 FEB 2010
- Manuscript Received: 23 DEC 2009
- silicone stenting;
- anatomical nasolacrimal duct obstruction;
- functional nasolacrimal duct obstruction;
- Level of Evidence: 2b
To compare surgical outcomes of primary powered endoscopic dacryocystorhinostomy (DCR) with selective or routine silicone stenting in anatomic and functional nasolacrimal duct obstruction (NLDO).
Prospective nonrandomized cohort study with historical control group.
Thirty-one consecutive primary powered endoscopic DCR procedures with selective stenting were performed for anatomic or functional NLDO. No stenting was used unless a tight Rosenmuller valve was appreciated when probing nasolacrimal system during surgery. Nasolacrimal system irrigation, dacryocystography, and lacrimal scintigraphy were used for preoperative assessment. Success was defined as absence of symptoms and patent nasolacrimal system. Comparisons were made with a historical cohort of 31 consecutive primary powered endoscopic DCR procedures with routine stenting.
The overall success rate was 79% (49/62), with 96.3% (26/27) success for anatomic and 65.7% (23/35) for functional NLDO. Success rates for anatomic NLDO were 100% (8/8) with selective stenting and 94.7% (18/19) with routine stenting (P > .05). Success rates for functional NLDO were 60.9% (14/23) with selective stenting and 75% (9/12) with routine stenting (P > .05). In the selective stenting group, 2/8 of the anatomic obstructions and 8/23 of the functional obstructions required stents.
Our study suggests that there is no difference in surgical outcomes of primary powered endoscopic DCR with selective or routine stenting in both anatomic and functional NLDO. We advocate a selective stenting approach for primary endoscopic DCR, whereby stents are only inserted when a tight common canaliculus opening is found during surgery. Laryngoscope, 2010