Korean J Ophthalmol.  2013 Apr;27(2):73-80. 10.3341/kjo.2013.27.2.73.

Effects of Nasopore Packing on Dacryocystorhinostomy

• Jang SY
• Lee KH
• Lee SY
• Yoon JS

• KMID: 1503796
• DOI: http://doi.org/10.3341/kjo.2013.27.2.73

Abstract

PURPOSE
To investigate the effects of placement of the absorbable packing material Nasopore at the anastomosis site of newly formed mucosal flaps on postoperative re-bleeding, discomfort, and on the success rate of dacryocystorhinostomy (DCR).
METHODS
A review of the medical records of patients with primary acquired nasolacrimal duct obstruction that underwent external or endonasal DCR by a single surgeon was performed. The degree of re-bleeding, discomfort, and postoperative results, including anatomical success, functional success and postoperative nasal findings such as granulation, synechiae, and membrane formation were compared in patients whose anastomosis site was packed with either Nasopore or Merocel, a non-absorbable packing material.
RESULTS
A total of 77 patients (101 eyes) were included. Of the 101 eyes, 30 were packed with Nasopore, while 71 were packed with Merocel. The Nasopore group showed significantly better results than the Merocel group in the degree of re-bleeding and the level of patient discomfort (p = 0.000, 0.039, respectively; Pearson's chi-square test), whereas there were no statistically significant differences between the two groups in postoperative anatomical and functional success (p > 0.05).
CONCLUSIONS
Nasopore significantly reduced postoperative nasal re-bleeding and patient discomfort during the early post-surgical period, but failed to show an effect on the postoperative anatomical and functional success of DCR.

Keyword

Absorbable packing material; Dacryocystorhinostomy; Discomfort; Nasopore; Postoperative bleeding

MeSH Terms

Adult
Aged
Dacryocystorhinostomy/*methods
Epistaxis/prevention & control
Female
Formaldehyde/therapeutic use
Hemostatics/therapeutic use
Humans
Lacrimal Duct Obstruction/*surgery
Male
Middle Aged
Nasolacrimal Duct/*surgery
Polyurethanes/*therapeutic use
Polyvinyl Alcohol/therapeutic use
Postoperative Complications/*prevention & control
Young Adult
Hemostatics
Polyurethanes
Formaldehyde
Polyvinyl Alcohol

Figure

• 

  Fig. 1 Application of Nasopore. (A,B) The edge of the nasal mucosal flap is held by a pre-placed 6-0 Vicryl suture. (A) Photograph taken after bicanalicular silicone intubation. (B) Nasopore was placed at the anastomosis site before anchoring the anterior mucosal sacs during external dacryocystorhinostomy. Note the silicone tube. (C) Taken immediately after anchoring of the anterior mucosal flaps. (D) Photograph shows Nasopore widening the narrow nasal space between the septum and lateral nasal wall.

• 

  Fig. 2 Proportions of the degree of re-bleeding and level of discomfort in patients who underwent dacryocystorhinostomy packed with Nasopore and Merocel.

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