Fusiform Anastomosis Technique with a Single Longitudinal Incision in the Lacrimal Sac in External Dacryocystorhinostomy

Abstract

Background In the present study, we aimed to evaluate the surgical outcomes of the fusiform anastomosis technique in external dacryocystorhinostomy (ex-DCR) that we designed in the form of a physiological tube, which sufficiently covered the bone ostium with the mucosa.

Material and Methods This was a retrospective observational study that included 145 eyes of 131 patients who underwent ex-DCR due to nasolacrimal duct obstruction. The patients were divided into two groups. Group 1 included 73 eyes of 65 patients who underwent fusiform anastomosis, and group 2 included 72 eyes of 66 patients who underwent conventional anterior and posterior flap anastomosis. The open nasolacrimal passage with lacrimal irrigation and the absence of reflux were accepted as anatomical success, and the absence of epiphora symptoms was accepted as functional success. The groups were compared in terms of anatomical success, functional success, and granulation tissue formation.

Results Anatomical success was observed in 73 eyes (100%) in group 1 and 66 eyes (91.6%) in group 2 (p = 0.01). Functional success was observed in 72 of 73 eyes (98.6%) in group 1 and 65 of 72 eyes (90.2%) in group 2 (p = 0.02). Nasal endoscopic examination performed in 32 eyes in group 1 and 28 eyes in group 2 revealed that granulation tissue was observed in 7 of 28 eyes (25%) in group 2, while there were no eyes with granulation tissue in group 1 (p = 0.01).

Conclusion The fusiform anastomosis technique in ex-DCR provided excellent anatomical success and extremely good functional success.

Zusammenfassung

Ziel In der vorliegenden Studie zielten wir darauf ab, die chirurgischen Ergebnisse der fusiformen Anastomosetechnik bei der externen Dakryozystorhinostomie (Ex-DZR) zu bewerten, die wir in Form eines physiologischen Schlauchs entworfen haben, der das Knochenostium ausreichend mit der Schleimhaut bedeckt.

Methoden Dies war eine retrospektive Beobachtungsstudie, in die 145 Augen von 131 Patienten eingeschlossen wurden, die sich einer Ex-DZR aufgrund einer Obstruktion des Tränennasengangs unterzogen hatten. Die Patienten wurden in 2 Gruppen eingeteilt. Gruppe 1 umfasste 73 Augen von 65 Patienten, die sich einer fusiformen Anastomose unterzogen, und Gruppe 2 umfasste 72 Augen von 66 Patienten, die sich einer konventionellen vorderen und hinteren Lappenanastomose unterzogen. Die offene nasolakrimale Passage mit Tränenflüssigkeit und das Fehlen von Reflux wurden als anatomischer Erfolg akzeptiert und das Fehlen von Epiphorasymptomen wurde als funktioneller Erfolg akzeptiert. Die Gruppen wurden hinsichtlich des anatomischen Erfolgs, des funktionellen Erfolgs und der Bildung von Granulationsgewebe verglichen.

Ergebnisse Anatomischer Erfolg wurde bei 73 Augen (100%) in Gruppe 1 und 66 Augen (91,6%) in Gruppe 2 beobachtet (p = 0,01). Ein funktioneller Erfolg wurde bei 72 von 73 Augen (98,6%) in Gruppe 1 und 65 von 72 Augen (90,2%) in Gruppe 2 beobachtet (p = 0,02). Eine nasale endoskopische Untersuchung an 32 Augen in Gruppe 1 und 28 Augen in Gruppe 2 ergab, dass das Granulationsgewebe in 7 von 28 Augen (25%) in Gruppe 2 beobachtet wurde, während es in Gruppe 1 keine Augen mit Granulationsgewebe gab (p = 0,01).

Schlussfolgerungen Die Technik der fusiformen Anastomose in Ex-DZR lieferte einen hervorragenden anatomischen Erfolg und einen extrem guten funktionellen Erfolg.

Key words

nasolacrimal duct obstruction - external DCR with fusiform anastomosis - reobstruction - anterior and posterior flap anastomosis - oculoplastic

Schlüsselwörter

Obstruktion des Tränennasengangs - externe DZR mit fusiformer Anastomose - Reobstruktion - vordere und hintere Lappenanastomose - okuloplastisch

Publication History

Received: 04 November 2021

Accepted: 28 November 2021

Article published online:
18 February 2022

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