| A clinical trial of endoscopic vs external dacryocysto-rhinostomy for partial nasolacrimal duct obstruction. | |
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MedLine Citation:
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PMID: 21779017 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ObjectiveA literature review revealed there is no outcome data for endoscopic endonasal dacryocystorhinostomy (EES-DCR) in the subgroup of patients with acquired partial nasolacrimal duct obstruction (NDO). This study aimed to compare the results of EES-DCR vsexternal DCR (ext-DCR) in the treatment of partial NDO.DesignThis study is designed as a prospective nonrandomised comparative clinical trial.ParticipantsIn total, 46 adult patients with acquired partial NDO participated in this study.MethodsPartial (sometimes called 'functional') NDO (epiphora in the presence of patent syringing) was confirmed by nuclear lacrimal scintigraphy or delayed drainage on dacryocystography. Patients with 'functional' epiphora from other causes were excluded. Post-operative outcome was assessed at 6 months. Overall, 21 (46%) patients had EES-DCR and 25 patients had (54%) ext-DCR.Main Outcome MeasuresSubjective success was based on patient symptoms, objective success on patency with syringing and a functioning rhinostomy evaluated using the functional endoscopic dye test (FEDT).ResultsIn total 18 out of 21 (86%) of EES-DCR patients had marked reduction (n=11) or complete resolution (n=7) and 25 out of 25 (100%) of ext-DCR had marked reduction (n=9) or complete resolution (n=16) of epiphora. In total 17 out of 18 (94%) of the EES-DCR patients with subjective success had a positive FEDT. All 25 out of 25 (100%) ext-DCR patients with subjective success had a positive FEDT. The three failed EES-DCR patients were all blocked on syringing. Statistically, EES-DCR does not achieve the same success rate as ext-DCR in this study (P=0.09, two-tailed Fisher's exact test, 0.045 one-tailed).ConclusionsBoth endoscopic and external DCRs provide satisfactory outcomes in acquired partial NDO. The success rate is nevertheless higher in ext-DCR compared with EES-DCR.Eye advance online publication, 22 July 2011; doi:10.1038/eye.2011.77. |
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Authors:
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F H Zaidi; S Symanski; J M Olver |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-22 |
Journal Detail:
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Title: Eye (London, England) Volume: - ISSN: 1476-5454 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703986 Medline TA: Eye (Lond) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Ophthalmology, Charing Cross and Hammersmith Hospitals, London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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