J Korean Ophthalmol Soc.  2017 Jul;58(7):757-762. 10.3341/jkos.2017.58.7.757.

Prognostic Factors Associated with Surgical Time of Endonasal Dacryocystorhinostomy

Affiliations
  • 1Department of Ophthalmology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea. ksm0724@inha.ac.kr

Abstract

PURPOSE
To determine the prognostic factors associated with surgical time of endonasal dacryocystorhinostomy (DCR).
METHODS
From April 2009 to June 2014, 66 eyes of 66 patients who underwent endonasal DCR for 5-year periods were retrospectively evaluated with regard to surgical time and several other factors. The factors were patient factors (age, sex), category of diagnosis (inflammation and non-inflammation), and systemic factors (diabetes mellitus [DM], hypertension [HTN], anticoagulant agents, sinusitis history). We divided the study period into three subperiods and compared their surgical time. The anatomical factor of thickness of the maxillary frontal process was evaluated by computed tomography (CT), as was the existence of symptom recurrence after surgery and reoperation according to surgical time. A total of 66 cases (right: 31, left: 35) were included. Any case with concurrent surgery, abnormal structure of the nasal cavity, or bilateral DCR was excluded.
RESULTS
Average surgical time was 49.95 minutes. Surgical time of endonasal DCR was short in inflammatory cases (p = 0.047), in the third surgical period (p = 0.001), and was correlated with thickness of the maxillary frontal process (p = 0.001). In addition, surgical time correlated with the existence of symptom recurrence after surgery and reoperation (p = 0.012).
CONCLUSIONS
It is considered that surgeon skill affects surgical time, and the thickness of the maxillary frontal process by CT will aid in the prediction of surgical time and success rate of endonasal DCR.

Keyword

Endonasal dacryocystorhinostomy (DCR); Prognostic factor; Success rate; Surgical time

MeSH Terms

Anticoagulants
Dacryocystorhinostomy*
Diagnosis
Humans
Hypertension
Nasal Cavity
Operative Time*
Recurrence
Reoperation
Retrospective Studies
Sinusitis
Anticoagulants

Figure

  • Figure 1. Measurement of the thickness of the maxillary fron-tal process by computed tomography scan. In axial view, we pointed the anterior lacrimal fossa (A) and maxillary-lacrimal suture line (B), and made parallel lines. At the center between two lines (mid-point of black line), thickness of frontal proc-ess was measured at medial side (double-headed arrow).

  • Figure 2. Factors associated surgical time. Age (A), sex (B). Inflammation vs. non-inflammation (C). Period (D). Systemic factors (E-H). Thickness of maxillary frontal process (I). There were statisti-cally significant differences with disease category (Inflammation vs. non-inflammation; p = 0.047), period (p = 0.027. 0.001), thickness of maxillary frontal process (Pearson correlation coefficient = 0.886, p = 0.001). The average of thickness of frontal process of maxillary bone was 1.595 mm. But, there were no statistically significant differ-ences with age (p = 0.443), sex (p = 0.515), and systemic factors (DM; p = 0.925, HTN; p = 0.791, anticoagulant history; p = 0.129, sinusitis history; p = 0.791). ANOVA = analysis of variance; DM = diabetes mellitus; HTN = hypertension; Hx = history.


Cited by  1 articles

Surgical Outcomes of Endonasal Dacryocystorhinostomy According to the Level of Obstruction in Dacryocystography
Kyoung Hwa Bae, Nam Chun Cho, Min Ahn
J Korean Ophthalmol Soc. 2018;59(4):301-306.    doi: 10.3341/jkos.2018.59.4.301.


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