Comparative study of the clinical profile of chronic dacryocystitis and chronic rhinosinusitis after external dacryocystorhinostomy

Impact of postoperative self-care on early outcomes in endoscopic dacryocystorhinostomy: a retrospective observational study

PURPOSE

This study aimed to evaluate the influence of standardized postoperative self-care protocols on short-term surgical outcomes in patients undergoing endoscopic dacryocystorhinostomy (En-DCR).

METHODS

This study evaluated the early prognosis (1 month) and personal care of 90 patients with 94 eyes who underwent endoscopic dacryocystorhinostomy (En-DCR) for Chronic dacryocystitis (CD). Surgical outcomes were divided into ostium grade and operative effect. Operative effect was judged by subjective symptom improvement, in addition to ostium assessment based on the results of nasal endoscopic review. We investigated the correlation between operative effect and ostium grade, and further analyzed the key factors influencing these outcomes during postoperative personal care.

RESULTS

The results of correlation analysis between operative effect and objective indicators showed that the outcomes of lacrimal duct irrigation (r = 0.444, P < 0.001), dye disappearance test (r = 0.217, P = 0.036), and ostium grade (r = 0.350, P < 0.001) were positively correlated with the operative effect of patients. The analysis of influencing factors during postoperative nursing showed that patients with nasal saline rinsing at least once a day after operation, nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day after operation and without postoperative respiratory tract infection had better ostium grades and operative effect (P < 0.05).

CONCLUSIONS

The early operative effect of endoscopic dacryocystorhinostomy (En-DCR) is closely related to the condition of the ostium. During postoperative personal care, patients who maintain nasal saline rinsing and nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day and reasonably prevent respiratory tract infection tend to have better recovery of early postoperative ostium and better operative effect. Medical staff should strengthen the home nursing guidance for patients after En-DCR day surgery.

A case report of chronic dacryocystitis caused by nasal stones

BACKGROUND

This paper reports a case of chronic dacryocystitis due to nasal stones.

CASE PRESENTATION

An 84-year-old male patient was admitted to the hospital with chronic dacryocystitis of the right eye due to tearing and purulent discharge from the right eye for more than 1 month. Antibiotic treatments such as gatifloxacin eye drops were given at other hospitals but did not relieve the symptoms. A computed tomography(CT) scan of the lacrimal duct in our department showed a high-density shadow in the right lacrimal sac area, hypertrophy of the right inferior turbinate, and many nasal calculi in the nasal cavity. The patient was transferred to our otolaryngology department for further treatment, and nasal stones were removed under nasal endoscopy. Three days after surgery, the symptoms affecting the patient's right eye gradually resolved. One month after surgery, the patient underwent a follow-up examination in the ophthalmology clinic; there was no lacrimal purulent discharge from the right eye, and the lacrimal duct could be flushed smoothly.

CONCLUSION

Chronic dacryocystitis is often caused by primary nasolacrimal duct obstruction. Cases of chronic dacryocystitis caused by secondary nasolacrimal duct obstruction due to nasal stones are rare in the clinic. This case can serve as a reference for the clinical diagnosis and treatment of chronic dacryocystitis.

Dacryocystitis secondary to neglected silicone tube in lacrimal duct for 10 years: A case report

INTRODUCTION

Contracture of dacryocyst by an implanted lacrimal silicone tube is rare. This report describes a unique case of secondary dacryocystitis and the contracture of dacryocyst caused by a lacrimal silicone tube that was placed in the lacrimal system for 10 years.

PATIENT CONCERNS

A 63-year-old female was diagnosed with chronic dacryocystitis at a local hospital and underwent surgical treatment 10 years ago. In the past month, the patient complained of persistent tearing and purulent secretion from the eyes.

DIAGNOSIS

The patient was diagnosed with secondary dacryocystitis, based on clinical features and the presence of the silicone stent, granulation tissue formation, and dacryocyst contracture in the lacrimal duct, as observed by nasal endoscopy.

INTERVENTIONS

For treatment, the implanted silicone tube in the patient was removed, the lacrimal duct and nasal mucosa was anastomosed, and a new lacrimal silicone tube was placed again.

OUTCOMES

Following the surgery, the patient recounted that there were no symptoms, and follow-up examinations performed over a 1-month period posttreatment revealed no recurrence of obstruction or dacryocystitis. Therefore, the surgeon removed the lacrimal drainage tube and asked the patient to return to the outpatient department regularly for examination.

CONCLUSION

The findings, in this case, suggest that silicone tubes are safe and effective, and can be placed in the lacrimal drainage system. However, in this patient, prolonged intubation caused chronic inflammation, granulation tissue formation, and dacryocyst contracture. Our findings could inform surgeons to consider the reasonable duration of intubation for treating cases of lacrimal obstruction, in order to avoid unnecessary complications.