Acquired Nasolacrimal Duct Obstruction
Conditions
Keywords
Posterior flap, DCR, NLDO
Brief summary
The aim of DCR is to form a new, mucosa-lined pathway between the lacrimal sac and the nasal cavity where tears can bypass a lacrimal obstruction and drain directly in the nose. The original external approach was described in 19046. In 1920s, mucosal flap anastomosis was added to the procedure as a modification7, and since then, many new modifications have been made to improve the original procedure.
Detailed description
Aim of The Study • To compare intraoperative details and postoperative endonasal endoscopic findings and their effects on success rate of external dacryocystorhinostomy with and without anastomosis of posterior mucosal flaps. Patients and Methods Study Design: This will be a prospective interventional comparative clinical study. It will include two groups according to the surgical procedure:- Group A: includes 30 eyes that will be treated with external DCR with anastomosis of posterior mucosal flaps . Group B: includes 30 eyes that will be treated with external DCR with amputation of posterior mucosal flaps . Study Population: Study participants will be: 60 eyes undergo external DCR . All patients included in this study will be verbally briefed about the details and the nature of the study & will sign a written consent according to the local Ethics Committee of Minia University Faculty of Medicine. The study will be conducted in Ophthalmology department, Minia university Hospital, Egypt.
Interventions
OTHERDCR
6\. An H shaped incision at the postero-inferior lacrimal sac is made, with a long anterior flap and shorter posterior flap. Similarly an H shaped incision at the nasal mucosa is made. The posterior flap of lacrimal sac is sutured with posterior flap of nasal mucosa in interrupted fashion using 6-0 vicryl sutures in Group A, while in Group B the posterior flap is trimmed without suturing.
Sponsors
Minia University
Study design
Allocation
NA
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Masking description
1. Patients with chronic dacryocystits, 2. primary nasolacrimal duct obstruction 3. Lacrimal mucocele 4. Lacrimal fistula
Intervention model description
All patients included in this study will be verbally briefed about the details and the nature of the study & will sign a written consent according to the local Ethics Committee of Minia University Faculty of Medicine. The study will be conducted in Ophthalmology department, Minia university Hospital, Egypt.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients with chronic dacryocystits, * primary nasolacrimal duct obstruction * Lacrimal mucocele * Lacrimal fistula
Exclusion criteria
* Recurrent cases. * Age under 5 years. * Associated nasal pathology. * Sever dry eye * Patients unfit for general anaesthesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Management of posterior flap in external DCR | patient evaluated at 2 months after surgery then at 4th month then 6th month | Evaluation of different methods of posterior flaps management in external dacryocystorhinostomy using nasal endoscopy for evaluation of outcomes |
Countries
Egypt
Contacts
Primary ContactMohammed Sayed Abdelmaaboud, MD
Backup ContactMohamed Farouk Sayed, Prof
Outcome results
None listed