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      Endoscopic dacryocystorhinostomy with an otologic T-type ventilation tube in repeated revision cases

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          Abstract

          Background

          To compare the frequency of appearance of complications, anatomical success and functional success after conventional endoscopic dacryocystorhinostomies (EN-DCRs) or EN-DCR with otologic T-Type ventilation tube combined with silicone tube intubation in repeated revision cases.

          Methods

          Twenty-two patients who had epiphora and recurrent dacryocystitis after at least a previous failed revision DCR as well as 22 patients receiving conventional EN-DCR only were enrolled in the study between January 2008 and December 2011. Operations were performed by using an otologic T-tube combined with silicone tube intubation. Oral antibiotics, nasal steroids, oral antihistamines, and antibiotic eyedrops were given to all cases. The ventilation tubes were removed 6 to 20 weeks after surgery.

          Results

          Of 22 cases, all cases achieved anatomical success, 19 cases were symptom free, and 3 cases had decreased continuation in complications with a functional success rate of 81.8%. The overall success rates were significantly higher than those in patients undertaking conventional EN-DCR only ( P < 0.01).

          Conclusion

          The revision endoscopic DCR has a high rate of failure. The usage of a T-type ventilation tube can significantly improve the success rate of surgery.

          Trial registration number

          ChiCTR-INR-17012160, retrospectively registered on July 27th, 2017.

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          Most cited references12

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          Management of unsuccessful lacrimal surgery.

          Two hundred and eight cases of failed dacryocystorhinostomy presenting to the Lacrimal Clinic at Moorfields Eye Hospital between 1970 and 1985 were reviewed. All cases underwent a further operation. The reasons for failure were usually apparent on reoperation. The surgical technique is described. A second dacryocystorhinostomy is a highly successful technique that spares both patient and surgeon the lifelong commitment to a bypass tube.
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            Long-term outcomes in revision powered endoscopic dacryocystorhinostomy.

            Long-term outcomes of revision dacryocystorhinostomy are less known. The aim of this study was to assess the long-term outcomes of revision powered endoscopic dacryocystorhinostomy (DCR).
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              Powered endoscopic dacryocystorhinostomy.

              Over the past ten years the interest in endoscopic dacryocystorhinostomy (DCR) has increased with improved instruments and endoscopic surgery skills. Although endoscopic DCR was first described in 1989, the technique has evolved over the past 15 years as the understanding of the anatomy and ability to achieve reliable and consistent results has improved. Powered endoscopic DCR is a reliable and effective technique for managing primary nasolacrimal duct obstruction in adults and children and for revision DCR.
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                Author and article information

                Contributors
                wsh19962012@sohu.com
                tingxu2000@sina.com
                bingf2000@126.com
                dajiangxiao2016@sina.cn
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                7 August 2017
                7 August 2017
                2017
                : 17
                : 138
                Affiliations
                ISNI 0000 0000 9255 8984, GRID grid.89957.3a, Department of Otorhinolarynogology, The Second People’s Hospital of Wuxi, , Nanjing Medical University, ; NO. 68, Zhongshan Road Wuxi, Nanjing, Jiangsu 214002 China
                Article
                539
                10.1186/s12886-017-0539-7
                5547563
                28784098
                f211006b-e24f-4242-9a78-d44b41d4161e
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 March 2017
                : 2 August 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Ophthalmology & Optometry
                endoscopic dacryocystorhinostomy,t-type ventilation tube,chronic dacryocystitis,clinical efficacy

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