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Sinonasal effects of external dacryocystorhinostomy. The Journal of Laryngology & Otology 2021; 135:791-794. [PMID: 34253269 DOI: 10.1017/s002221512100181x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE External dacryocystorhinostomy is thought to cause mucociliary dysfunction by damaging the mucosa, in turn affecting ciliary activity and mucus quality. This study investigated the effect of external dacryocystorhinostomy on sinonasal function. METHODS Patients scheduled for unilateral external dacryocystorhinostomy who underwent endoscopic nasal examination and paranasal sinus computed tomography were included in this study. A saccharine test was performed on the planned surgical side and the mucociliary clearance time was determined. The sinonasal quality of life was measured in all patients, pre-operatively and at six months post-operatively, using the Sino-Nasal Outcome Test-22. The Lund-Kennedy endoscopic score was also determined in all patients, both pre- and post-operatively. RESULTS The study comprised 28 patients (22 females and 6 males). A statistically significant difference was found between the pre- and post-operative saccharine test results (p = 0.006), but not between the pre- and post-operative Sino-Nasal Outcome Test-22 scores (p > 0.05). CONCLUSION This study is one of only a few to investigate the effect of external dacryocystorhinostomy on sinonasal function. The results showed that external dacryocystorhinostomy impairs mucociliary clearance. The surgical procedure is well tolerated and does not significantly change nasal symptom scores.
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Soriano LM, Damasceno NA, Herzog Neto G, Damasceno EF. Comparative study of the clinical profile of chronic dacryocystitis and chronic rhinosinusitis after external dacryocystorhinostomy. Clin Ophthalmol 2019; 13:1267-1271. [PMID: 31409965 PMCID: PMC6643063 DOI: 10.2147/opth.s200923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/20/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the clinical profile of patients with chronic dacryocystitis (CDC) with and without associated chronic rhinosinusopathies who had been submitted to external dacryocystorhinostomy (EDCR). Methods This was a retrospective, observational, and longitudinal study that included all patients diagnosed with CDC who were submitted to EDCR at the Antonio Pedro University Hospital. Patients were divided into two groups, with and without rhinosinusopathies (Group I and Group II, respectively). The following variables were assessed to compare the Group I and Group II: age, ethnicity, epiphora, discharge by expression of the lacrimal sac, duration of the CDC, and previous history of CDC exacerbation. Results The study included a total of 78 patients, 22 patients (28.2%) in Group I and 56 patients (71.8%) in Group II. The mean age was 64.3 (±19.7) years. In Group I and II predominated elderly, female, and White (p=0.93, p=0.38, p=0.77). In relation to the clinical characteristics, most of the patients presented epiphora and discharge by compression of the lacrimal sac in both Groups (p=0.61, p=0.44). In relation to a previous history of exacerbations of the CDC, six patients in Group I and four patients in Group II presented it as purulent discharge (p=0.04). Conclusion Chronic rhinosinusopathies may favor episodes of exacerbations of chronic dacryocystitis in particular with the presence of purulent discharge.
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Affiliation(s)
- Luciana Mc Soriano
- Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil
| | - Nadyr A Damasceno
- Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil.,Department of Ophthalmology, Hospital Naval Marcílio Dias, Rio de Janeiro, Brazil
| | | | - Eduardo F Damasceno
- Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil
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Rodrigues F, Freire AP, Uzeloto J, Xavier R, Ito J, Rocha M, Calciolari R, Ramos D, Ramos E. Particularities and Clinical Applicability of Saccharin Transit Time Test. Int Arch Otorhinolaryngol 2019; 23:229-240. [PMID: 30956710 PMCID: PMC6449131 DOI: 10.1055/s-0038-1676116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 10/06/2018] [Indexed: 11/02/2022] Open
Abstract
Introduction The importance of mucociliary clearance (MCC) for the respiratory system homeostasis is clear. Therefore, evaluating this defense mechanism is fundamental in scientific research and in the clinical practice of pulmonology and of associated areas. However, MCC evaluation has not been so usual due to the complexity of methods that use radiolabeled particles. Nevertheless, as an interesting alternative, there is the saccharin transit time (STT) test. This method is reproducible, simple to perform, noninvasive, does not demand high costs, and has been widely used in studies of nasal MCC. Although the STT test is widely used, there is still lack of a detailed description of its realization. Objective The present literature review aims to provide basic information related to the STT test and to present the findings of the previous studies that used this method, discussing variations in its execution, possible influences on the obtained results and limitations of the method, as well as to relate our experience with the use of STT in researches. Data Synthesis There are several factors that can alter the results obtained from STT tests, which would raise difficulties with proper interpretation and with the discussion of the results among different studies. Conclusions Saccharin transit time is a widely used method for the evaluation of nasal MCC, and therefore, the standardization related to the previous and concurrent to test orientations, and also its execution, become essential to improve its accuracy, and allow comparisons among different studies.
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Affiliation(s)
- Fernanda Rodrigues
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Ana Paula Freire
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Juliana Uzeloto
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Rafaella Xavier
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Juliana Ito
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Marceli Rocha
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Renata Calciolari
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Dionei Ramos
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
| | - Ercy Ramos
- Department of Physiotherapy, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Presidente Prudente, Presidente Prudente, SP, Brazil
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Acute post-operative rhinosinusitis following endonasal dacryocystorhinostomy. Eye (Lond) 2013; 27:1130-6. [PMID: 23846379 DOI: 10.1038/eye.2013.147] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 05/27/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate the incidence and risk factors for acute rhinosinusitis (ARS) following endoscopic dacryocystorhinostomy (EnDCR). METHODS Retrospective single-surgeon interventional case series, including 196 consecutive patients undergoing 203 endonasal DCR, with clinical and radiological evidence of nasolacrimal duct or common canalicular obstruction. Pre-operative lacrimal and sinonasal clinical assessment and imaging, intraoperative endoscopic video recording, and post-operative clinical and endoscopic findings were analysed for cases of ARS occurring within the first 4 weeks following DCR among patients with and without a past history of chronic rhinosinusitis (CRS). Surgical complications and outcomes at 12 months and management of ARS are reported. RESULTS Three patients (1.5%) developed ARS within the first 5 post-operative days, none of which had experienced peri-operative complications and all had a past history of CRS. The rate of CRS in this cohort of 196 patients was 10.2% (n=20), of which 15% (n=3) developed ARS, although none had symptoms of CRS at the time of surgery; one had undergone previous sinus surgery. Presenting symptoms of ARS included facial pain, tenderness over the affected sinus, and nasal discharge; all patients responded to oral antibiotic therapy. DISCUSSION The rate of ARS following EnDCR was 1.5%. In those with a prior history of CRS, it was 15% (P=0.009). ARS developed within the first post-operative week among patients with a past history of CRS, who were asymptomatic at the time of surgery, and responded to oral antibiotics. CRS may be a risk factor for the development of post-operative ARS.
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