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      Clinical Study of Endoscopic Endonasal Conjunctivodacryocystorhinostomy with Jones Tube Placement

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          Purpose: To evaluate the efficacy of endoscopic endonasal primary conjunctivodacryocystorhinostomy (CDCR) and revision CDCR after primary CDCR. Methods: Twenty-four patients who had undergone endoscopic endonasal CDCR with a Jones tube and who were followed up for over 6 months at our hospital were reviewed retrospectively. Our analysis included success rate, operation times, and causes of failure. Results: The indications for revision CDCR were Jones tube prolapse and inadequate tube length. The initial success rate in the primary and revision groups were 78.6% (11/14) and 100% (10/10), respectively, and their mean operation times were 24 min (± 6.3) and 21 min (± 6.1), respectively. Main causes of failure included inaccurate tube length and abnormal tube position. Conclusions: Endoscopic endonasal CDCR appears to be a reasonable revision and primary approach, because it allows Jones tube length to be measured accurately during surgery, and an 18- to 20-mm Jones tube length was used in most cases.

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          Prospective randomized comparison of external dacryocystorhinostomy and endonasal laser dacryocystorhinostomy.

          The introduction of endonasal laser dacryocystorhinostomy (ENL-DCR) in the early 1990s showed great promise of changing dacryocystorhinostomy into an elegant, minimally invasive procedure from the traditional external dacryocystorhinostomy (EXT-DCR). This prospective, randomized study compares these two operations, their success rates, surgical durations, and postoperative symptoms. A total of 64 cases in 61 patients with primary acquired nasolacrimal sac or duct obstruction were divided into 2 subgroups by symptoms (simple epiphora and chronic dacryocystitis). These patients were randomized within both subgroups into 2 operation groups with 32 cases in each group. Altogether, 32 EXT-DCRs and 32 ENL-DCRs were performed. The silicone tube was removed at 6 months after surgery. The final follow-up visit was at 1 year after surgery. The patency of the lacrimal passage was investigated by irrigation, and patients were questioned about their symptoms. The patency of the lacrimal passage to irrigation and the duration of surgery were measured. The success rate at 1 year after surgery was 91% for EXT-DCR and 63% for ENL-DCR after primary surgery. The difference was statistically significant (P = 0.016). The surgical duration for ENL-DCR was three times shorter than for EXT-DCR, the average duration being 23 minutes and 78 minutes, respectively (P < 0.0001). The EXT-DCR, when compared with ENL-DCR, seems to provide superior operation results in primary acquired nasolacrimal duct obstruction.
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            Endoscopic conjunctivodacryocystorhinostomy with Jones tube placement


              Author and article information

              S. Karger AG
              December 2006
              18 December 2006
              : 221
              : 1
              : 36-40
              aKong Eye Medical Center, bDepartment of Ophthalmology, Gachon University Gil Medical Center, Incheon, and cDepartment of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
              96520 Ophthalmologica 2007;221:36–40
              © 2007 S. Karger AG, Basel

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              Page count
              Figures: 2, Tables: 2, References: 15, Pages: 5
              Original Paper


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