About endonasal laser dacryocystorhinostomy unfavorable outcomes

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Dacryocystorhinostomy (DCRS) performed with a variety of surgical approaches is the most common surgical procedure aimed at restoring the tear outflow. However, regardless of the chosen method, surgery sometimes provides only temporary effect and requires re-intervention (revision). This article presents the analysis of clinical observation of a case series including 76 patients with lacrimal outflow impairment who, in 2014-2015, underwent endonasal endoscopic laser DCRS at the Otorhinolaryngology Department of the First Pavlov State Medical University of St. Petersburg. Among these, re-operation to restore the lacrimal passage was required necessary in 19.7% of cases. The authors concluded that the most frequent reasons of DCRS insufficiency are intractable individual anatomical features of nasal structures and/or lacrimal apparatus of the patients (including atypical anatomy of the lacrimal sac and nasolacrimal duct) and high regeneration ability of the nasal cavity mucous membrane. The probability of re-stenosis increases with previously performed DCRS with unstable result in the patient’s history, concomitant somatic general diseases (diabetes, arterial hypertension, etc.). These reasons may be successfully overcome when choosing an endoscopic approach with laser technology.

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About the authors

Natalya Y Beldovskaya

First I.P. Pavlov State Medical University

Email: beldovskay@mail.ru
MD, PhD, assistant professor. Ophthalmology Department

Sergey A Karpishchenko

First I.P. Pavlov State Medical University

Email: Karpichenkos@mail.ru
professor, head of department. Otorhinolaryngology Department

Ol’ga A Kulikova

First I.P. Pavlov State Medical University

Email: Olgakul92@mail.ru
MD, otorhinolaryngologist. Otorhinolaryngology Department

Svetlana V Baranskaya

First I.P. Pavlov State Medical University

Email: sv-v-b@mail.ru
MD, postgraduate student. Otorhinolaryngology Department


  1. Азнабаев М.Т. и др. Лазерная дакриоцисториностомия. - Уфа, 2005. - 152 c. [Aznabaev MT, et al. Lazernaya dakriotsistorinostomiya. Ufa; 2005. 152 p. (In Russ).]
  2. Белоглазов В.Г. Современные принципы эндоназальной хирургии слёзоотводящих путей // Вестник офтальмологии. - М.,1997. - Т. 3. - № 6. - С. 14-17. [Beloglazov VG. Sovremennye printsipy endonazal’noi khirurgii slezootvodyashchikh putei. Vestnik oftal’mologii. Moscow;1997;3(6):14-17. (In Russ).]
  3. Бржеский В.В., Астахов Ю.С., Кузнецова Н.Ю. Заболевания слёзного аппарата. - СПб.: Издательство Н-Л, 2009. - С. 72-94. [Brzheskii VV, Astakhov YS, Kuznetsova NY. Zabolevaniya sleznogo apparata. Saint Petersburg: Izdatel’stvo N-L; 2009:72-94. (In Russ).]
  4. Волков В.В., Султанов М.Ю. Наружная дакриоцисториностомия. - Л., 1975. - c. 45. [Volkov VV, Sultanov MY. Naruzhnaya dakriotsistorinostomiya. Leningrad; 1975. P. 45. (In Russ).]
  5. Карпищенко С.А., Болознева Е.В., Баранская С.В. Остеома верхнечелюстной пазухи: особенности клинической картины и тактика лечения // Folia Otorhinolaryngologiae et pathologiae respiratoriae. - 2015. - T. 21. - № 2. - С. 55-56. [Karpishchenko SA, Bolozneva EV, Baranskaya SV. Osteoma of the maxillary sinus: clinical features and treatment strategy. Folia Otorhinolaryngologiae et pathologiae respiratoriae. 2015;21(2):55-56. (In Russ).]
  6. Кузнецова Н.Ю., Астахов Ю.С. Современные технологии в диагностике и лечении слёзоотводящих путей // Окулист. - 2005. - № 2-3. - С. 6-7. [Kuznetsova NY, Astakhov YS. Sovremennye tekhnologii v diagnostike i lechenii slezootvodyashchikh putei. Okulist. 2005;(2-3):6-7. (In Russ).]
  7. Поляновская А.С., Зубарева А.А., Белдовская Н.Ю., и др. Использование конусно-лучевой компьютерной томографии для определения оптимальной лечебной тактики у пациентов с патологией слёзоотведения // Офтальмологические ведомости. - 2016. - Т. IX. - № 1. - С. 14-18. [Polyanovskaya AS, Zubareva AA, Beldovskaya NY, et al. Cone-beam computerized tomography use for determination of optimal treatment tactics in patients with tear drainage system pathology conditions. Ophthalmology Journal. 2016;9(1):14-18. (In Russ).] doi: 10.17816/OV9114-18.
  8. Черкунов Б.Ф. Заболевания слёзных органов. - Самара, 2001. - C. 296. [Cherkunov BF. Zabolevaniya sleznykh organov. Samara; 2001:296.]
  9. Hartikainen J, Antila J, Varpula M, et al. Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Laryngoscope 1998;108:1861-6. doi: 10.1097/00005537-199812000-00018.
  10. Hartikainen J, Grenman R, Puukka P, Seppa H. Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Ophthalmology. 1998;105(6):1106-13. doi: 10.1016/S0161-6420(98)96015-8.
  11. Paik J, Won-Kyung C, Suk-Woo Y. Comparison of endoscopic revision for failed primary external versus endoscopic dacryocystorhinostomy. Clinical & Experimental Ophthalmology. 2013; 41(2):116-121. doi: 10.1111/j.1442-9071.2012.02844.x.
  12. Vivekanand U, Gonsalves S. Etiologies of Failed External Dacryocystorhinostomy - A Case Series. Indidan journal of applied research. 2014;4(3).
  13. Zaidi FH, Symanski S, Olver JM. A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction. Eye (Lond). 2011;25(9):1219-24. doi: 10.1038/eye.2011.77.



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Copyright (c) 2016 Beldovskaya N.Y., Karpishchenko S.A., Kulikova O.A., Baranskaya S.V.

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