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https://hdl.handle.net/2440/79223
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Type: | Journal article |
Title: | Endonasal dacryocystorhinostomy for nasolacrimal duct obstruction in patients with sarcoidosis |
Author: | Avisar, I. McNab, A. Dolman, P. Patel, B. deSousa, J. Selva-Nayagam, D. Malhotra, R. |
Citation: | Orbit: the international journal on orbital disorders, oculoplastic and lacrimal surgery, 2013; 32(4):225-230 |
Publisher: | Taylor & Francis The Netherlands |
Issue Date: | 2013 |
ISSN: | 0167-6830 1744-5108 |
Statement of Responsibility: | Inbal Avisar, Alan A. McNab, Peter J. Dolman, Bhupendra Patel, Jean-Louis deSousa, Dinesh Selva, and Raman Malhotra |
Abstract: | <h4>Purpose</h4>To evaluate the outcomes of endonasal dacryocystorhinostomy (EN-DCR) surgery in patients with sarcoidosis.<h4>Methods</h4>Retrospective chart review of all patients with sarcoidosis undergoing EN-DCR in 6 practices from 1999-2011.<h4>Results</h4>We included 18 procedures in 14 patients (8 female, 6 male) who underwent EN-DCR for acquired NLDO secondary to sarcoidosis. The mean age was 53.7 (range 38-82). The presenting symptom in all cases was epiphora. Eight patients (57%) complained of having additional nasal congestion. Surgery was performed using endoscopic powered-type DCR with flaps in 12/18 (67%) and non-endoscopic mechanical EN-DCR in 6/18 (33%). In 15 (83%) cases the lacrimal sac and nasal mucosa appeared abnormally yellowish, crusty, oedematous and friable. Five patients were treated with pre-operative oral steroid and overall 8 patients had oral prednisolone post operatively, 30-60 mg tapered within 10 days-8 weeks. One patient had difficulties in tapering down the oral steroids at 6 months of follow-up. All patients were free of epiphora and patent to syringing, with nasal endoscopy revealing free flow of fluorescein through the ostium at a mean follow-up of 11.3 months (median follow-up 9 months).<h4>Conclusions</h4>All 18 cases of acquired nasolacrimal duct obstruction secondary to sarcoidosis were treated successfully with EN-DCR. An abnormal appearance of the nasal mucosa is an important sign. Nasal congestion is a frequent sign. A successful outcome may not depend on intensive long-term therapy with local or systemic steroids. Mechanical or powered EN-DCR for nasolacrimal duct obstruction secondary to sarcoidosis achieves encouraging medium-term outcomes. |
Keywords: | Dacryocystorhinostomy endonasal nasolacrimal duct obstruction sarcoidosis |
Rights: | © Informa Healthcare USA, Inc. |
DOI: | 10.3109/01676830.2013.788670 |
Published version: | http://dx.doi.org/10.3109/01676830.2013.788670 |
Appears in Collections: | Aurora harvest Opthalmology & Visual Sciences publications |
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