Endonasal Dacryocystorhinostomy; the learning curve and our experience
Endonasal Dacryocystorhinostomy; the learning curve and our experience
Tarih
2021-12-01
Yazarlar
Emre, İsmet Emrah
Çelebi, Ali Rıza Cenk Çelebi
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
Acıbadem Mehmet Ali Aydınlar Üniversitesi
Dergi Adı
Özet
ABSTRACT
Aim: It was aimed to give an insight on the learning curve adopted by an ophthalmic surgeon while performing endonasal
dacryocystorhinostomy under the supervision of an otolaryngologist with the results experienced during this survey.
Materials and Methods: In this retrospective study, consecutive cases with endonasal dacryocystorhinostomy (DCR) surgery
were performed by a single ophthalmic surgeon while a second otolaryngologist was overlooking the procedures. A total of 29
surgeries were performed on 23 patients. Patients that were diagnosed with complete nasolacrimal duct obstruction were then
evaluated and proceeded to the surgery. The intraoperative video was recorded in all surgical cases and recording time was noted
for each case. All of the complications that occurred during or at the postoperative stages were noted.
Results: The mean age of the 23 patients was 55.25±18.6 years (15 y-80 y), of which 20 cases (87%) were female. The left side
was involved in 69% (20/29) of cases. At the final follow-up of the mean of 12,4 months, the anatomical and functional success
was achieved in 89% (26/29) cases. The mean time spent in the operating theatre was 84±17.2 minutes (range, 40–110 min). It
was found that the only 3 failed surgeries were in the first 5 surgeries performed with no surgical failure in the remaining 24 eyes.
Conclusions: Endonasal dacryocystorhinostomy is a safe, effective and cosmetically pleasing surgery for the treatment of
nasolacrimal duct obstruction. Although it has a somewhat longer learning curve than some surgeries, once handling of the
endoscope has been mastered and familiarity with the surgical field is improved, the duration of the surgery will decrease
significantly. We believe multidisciplinary coordination plays an important role in decreasing potential complication rates and
also in perfecting the technique.