The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
R K Dortzbach - One of the best experts on this subject based on the ideXlab platform.
-
results of endonasal laser assisted Dacryocystorhinostomy
Ophthalmology, 1994Co-Authors: Andrew G Boush, Bradley N Lemke, R K DortzbachAbstract:Background: Endonasal laser-assisted Dacryocystorhinostomy has been a subject of much interest since its introduction in 1990, offering the potential advantages of decreased postoperative morbidity and the lack of a cutaneous scar. In this study, the authors report the results of 46 endonasal laser-assisted Dacryocystorhinostomy procedures performed on 42 patients between February 1991 and July 1992. Methods: The medical records of all patients undergoing endonasal laser-assisted Dacryocystorhinostomy procedures were reviewed retrospectively in detail. Patients undergoing laser-assisted external dacryocystorhinostomies or conjunctivo-dacryocystorhinostomies and those with follow-up periods less than 4 months were not included in the study. Results: A total of 46 endonasal laser-assisted Dacryocystorhinostomy procedures were performed. Of these, 32 were successful and 14 failed after a single attempt, yielding a success rate of 70% (32/46). Of the 14 patients with failed procedures, 6 underwent a second endonasal laser-assisted Dacryocystorhinostomy. Of these, five were successful. The success rate calculated on the basis of one or two attempts was 80% (37/46). Conclusions: The science and technology of endonasal laser-assisted Dacryocystorhinostomy is undergoing a continuous process of evolution as a number of modifications are introduced, including better patient selection, more complete tissue removal at the osteotomy site, and the adjunctive use of mitomycin C. As this process continues, it is likely that the success rates in this modality will improve, making it an increasingly attractive alternative to external Dacryocystorhinostomy.
John J Woog - One of the best experts on this subject based on the ideXlab platform.
-
Dacryocystorhinostomy for acquired nasolacrimal duct stenosis in the elderly 80 years of age
Ophthalmology, 2017Co-Authors: Andrea A Tooley, John J Woog, Kyle N Klingler, George B Bartley, James A Garrity, David O Hodge, Elizabeth A BradleyAbstract:Purpose The incidence of acquired nasolacrimal duct obstruction (NLDO) increases with age. Dacryocystorhinostomy, the definitive treatment for NLDO, has a high success rate (80%–100%) with a low complication rate (1%–6%), but surgical outcomes have not been reported previously specifically for an elderly population, in which there may be increased risk for intraoperative and postoperative complications. The purpose of this study was to examine surgical outcomes and complication rates of Dacryocystorhinostomy in an elderly population. Design Retrospective cohort study. Participants Patients 80 years of age or older undergoing external Dacryocystorhinostomy at the Mayo Clinic between January 1, 1990, and December 31, 2010, were compared with a matched control group of younger patients (40–79 years of age) undergoing external Dacryocystorhinostomy by the same surgeons. Methods We reviewed the medical charts for patients as described above. Data abstracted from patient medical records included symptomatic relief and complications such as tube protrusion, infection, persistent bleeding, and return to operating room. Statistical analysis included a 2-sample t test to compare continuous variables, chi-square testing for categorical comparisons, and the generalized estimating equation model to control for nonindependence. Main Outcome Measures Primary end point was symptomatic improvement at last follow-up. Secondary end points included anatomic patency, adverse event rate, and return to operating room within 1 month of surgery. Results Forty-two dacryocystorhinostomies (32 patients) were performed in the elderly group. The control group comprised 73 dacryocystorhinostomies in 63 patients. Resolution of symptom rate at last follow-up was 64% in the elderly group versus 86% in the younger cohort ( P = 0.02). Although there was no difference between groups with respect to common postoperative complications, there was a higher rate of predefined serious complications in the elderly group (5 events vs. 1 event; P = 0.01). There was no difference between groups regarding need for additional eyelid surgery ( P = 0.30). Conclusions Although most elderly patients experience symptom resolution after Dacryocystorhinostomy, the rate of symptom resolution was lower than that of younger patients. The risk of routine complications was similar between the groups. The risk of serious complications was higher in the elderly group.
-
Endoscopic Dacryocystorhinostomy and ConjunctivoDacryocystorhinostomy
Otolaryngologic Clinics of North America, 2006Co-Authors: John J Woog, Raj SindwaniAbstract:Intranasal approaches to the correction of lacrimal outflow obstruction initially were described more than 100 years ago, but they have gained renewed popularity with the recent development of the field of endoscopic sinus surgery. Endoscopic Dacryocystorhinostomy (EDCR) surgery may be considered in many patients who have lacrimal outflow obstruction. It may be particularly advantageous in patients who have concomitant sinonasal disease, patients with a history of radiation therapy, pediatric patients, and in revision procedures. Advantages of the endoscopic technique include excellent visualization, the ability to evaluate the location and size of the rhinostomy site thoroughly, and the avoidance of a facial scar. Recent studies suggest that the success rates of EDCR are comparable to those achieved through traditional external Dacryocystorhinostomy.
-
endonasal endoscopic Dacryocystorhinostomy in children
Archives of Otolaryngology-head & Neck Surgery, 1998Co-Authors: Michael J Cunningham, John J WoogAbstract:Objective To describe the indications, technique, and results of endonasal endoscopic Dacryocystorhinostomy in children with congenital and acquired disorders of the nasolacrimal system. Design Retrospective case series. Setting Tertiary care hospital. Patients Four children ranging in age from 10 months to 6 years. Intervention Primary or revision endonasal endoscopic Dacryocystorhinostomy performed via a joint otolaryngologic-ophthalmologic team approach. Main Outcome Measures Incidence of surgical complications and postoperative clinical status. Results The duration of follow-up was 10 to 24 months with a successful clinical outcome in all 4 children. Two procedures were complicated by nasal vestibule skin abrasions secondary to rotation of the drill shaft. Conclusions Despite the technical challenges posed by the small anatomical dimensions of the pediatric nasal airway, the combination of proper otolaryngologic endoscopic instrumentation and ophthalmologic lacrimal sac transillumination guidance allows for the safe and successful performance of endonasal endoscopic Dacryocystorhinostomy in the pediatric population.
-
holmium yag endonasal laser Dacryocystorhinostomy
American Journal of Ophthalmology, 1993Co-Authors: John J Woog, Ralph Metson, Carmen A PuliafitoAbstract:Previously described techniques of endonasal laser-assisted Dacryocystorhinostomy appear to offer several advantages over conventional external Dacryocystorhinostomy, including the following: (1) decreased disruption of medial canthal anatomy, (2) enhanced hemostasis, and (3) avoidance of a cutaneous scar. Although good results were achieved, several limitations of early laser-assisted techniques have been noted, including difficulty in removal of the thick bone of the anterior lacrimal crest and inability to obtain specimens of lacrimal sac mucosa for biopsy purposes. In a series of 40 consecutive, primary endonasal Dacryocystorhinostomy procedures, we used the holmium: YAG (Ho: YAG) laser for bone removal and endoscopic sinus surgical instrumentation to obtain lacrimal sac biopsy specimens. Intraoperative hemostasis was excellent and medial canthal scarring was avoided in all patients. The overall long-term ostium patency rate in our series was 82%. Several technical modifications adopted in the latter part of our series, including use of a small drill for supplemental bone removal, extensive removal of lacrimal sac mucosa, and use of a double stent, appeared to enhance this success rate.
Andrew G Boush - One of the best experts on this subject based on the ideXlab platform.
-
results of endonasal laser assisted Dacryocystorhinostomy
Ophthalmology, 1994Co-Authors: Andrew G Boush, Bradley N Lemke, R K DortzbachAbstract:Background: Endonasal laser-assisted Dacryocystorhinostomy has been a subject of much interest since its introduction in 1990, offering the potential advantages of decreased postoperative morbidity and the lack of a cutaneous scar. In this study, the authors report the results of 46 endonasal laser-assisted Dacryocystorhinostomy procedures performed on 42 patients between February 1991 and July 1992. Methods: The medical records of all patients undergoing endonasal laser-assisted Dacryocystorhinostomy procedures were reviewed retrospectively in detail. Patients undergoing laser-assisted external dacryocystorhinostomies or conjunctivo-dacryocystorhinostomies and those with follow-up periods less than 4 months were not included in the study. Results: A total of 46 endonasal laser-assisted Dacryocystorhinostomy procedures were performed. Of these, 32 were successful and 14 failed after a single attempt, yielding a success rate of 70% (32/46). Of the 14 patients with failed procedures, 6 underwent a second endonasal laser-assisted Dacryocystorhinostomy. Of these, five were successful. The success rate calculated on the basis of one or two attempts was 80% (37/46). Conclusions: The science and technology of endonasal laser-assisted Dacryocystorhinostomy is undergoing a continuous process of evolution as a number of modifications are introduced, including better patient selection, more complete tissue removal at the osteotomy site, and the adjunctive use of mitomycin C. As this process continues, it is likely that the success rates in this modality will improve, making it an increasingly attractive alternative to external Dacryocystorhinostomy.
Deborah Vanderveen - One of the best experts on this subject based on the ideXlab platform.
-
Endoscopic Dacryocystorhinostomy (OCR)
Operative Dictations in Ophthalmology, 2017Co-Authors: Maan Alkharashi, Deborah VanderveenAbstract:Multiple recent published studies have confirmed the value of the endoscopic Dacryocystorhinostomy technique in the treatment of lacrimal obstruction. Significant refinements in technique and instrumentation coupled with an improved understanding of the endoscopic surgical anatomy are largely responsible for the excellent success rates now reported. The advantages of endoscopic Dacryocystorhinostomy include the absence of skin incision and scar, preservation of the pump mechanism of the orbicularis oculi muscle, less disruption of medial canthal anatomy, decreased operating time, decreased intraoperative bleeding, and the ability to address concurrently nasal cavity or paranasal sinus abnormalities. Success appears to be dependent on several key aspects: (1) a thorough understanding of the endoscopic anatomy and location of the lacrimal sac, (2) efficient removal of frontal process of maxilla to expose completely the medial wall of the lacrimal sac, and (3) careful incision of the sac to achieve adequate exposure of the common internal punctum. This article describes the authors' method for performing endoscopic Dacryocystorhinostomy. © 2006 Elsevier Inc. All rights reserved.
E. Bradley Strong - One of the best experts on this subject based on the ideXlab platform.
-
Ultrasonic bone aspirator assisted endoscopic Dacryocystorhinostomy
American Journal of Otolaryngology - Head and Neck Medicine and Surgery, 2016Co-Authors: Toby O. Steele, Machelle Wilson, E. Bradley StrongAbstract:Objective To evaluate the ultrasonic bone aspirator versus traditional powered drill technique for use in endoscopic Dacryocystorhinostomy. Study design Retrospective chart review. Setting Academic institution. Subjects and methods A retrospective chart review of all patients undergoing endoscopic Dacryocystorhinostomy from June 2010 through May 2014 was performed. Data were collected from 63 eyes of 63 patients. Recorded data points include: age, gender, etiology of epiphora, procedure type, success rate, need for septoplasty, and length of follow-up. Surgical failure was defined as no improvement in epiphora, postoperative dacryocystitis, or inability to irrigate the lacrimal system post-operatively. Results Sixty three consecutive patients underwent endonasal endoscopic Dacryocystorhinostomy. Twenty nine patients underwent powered microdrill DCR (pDCR); 34 patients underwent ultrasonic bone aspirator DCR (uDCR). There was no statistically significant difference between groups in terms of age or gender. The success rates were: pDCR 86.2% and uDCR 94.1% (p = 0.4). Concurrent septoplasty was performed in 48% of pDCR patients and 21% of uDCR patients (p = 0.03) There was no significant difference in surgical success when septoplasty was controlled for (p = 0.39). Conclusion Ultrasonic bone aspirator Dacryocystorhinostomy has a similar success rate to traditional powered microdrill Dacryocystorhinostomy.
-
Endoscopic Dacryocystorhinostomy.
Craniomaxillofacial trauma & reconstruction, 2013Co-Authors: E. Bradley StrongAbstract:External Dacryocystorhinostomy was described in early 20th century. The introduction of nasal endoscopy and endoscopic sinus surgery in the 1980s paved the way for a transnasal endoscopic approach to lacrimal system. This article will review the indications and surgical techniques used for endoscopic Dacryocystorhinostomy.
