1
|
Locatello LG, De Zan ER, Tarantini A, Lanzetta P, Miani C. External dacryocystorhinostomy: A critical overview of the current evidence. Eur J Ophthalmol 2024:11206721241249214. [PMID: 38689455 DOI: 10.1177/11206721241249214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
PURPOSE External dacryocystorhinostomy (ext-DCR) is still considered the gold standard in the treatment of distal lacrimal duct obstruction. Despite an overall high success rate, some patients do relapse after surgery and the ideal perioperative management has not been identified yet. The purpose of this study is to critically discuss the published evidence in the last five years on the medical and surgical management of external dacryocystorhinostomy. Furthermore, the drawbacks of the available literature and the perspectives in this field will be also highlighted. METHODS Systematic review of the literature in the last 5 years by using PubMed and Google Scholar. RESULTS A total of 64 articles were included. Many technical modifications and surgical refinements have been proposed but a formal comparison among the various techniques is hampered by methodological heterogeneity. The use of local anesthesia, and the perioperative adjunctive techniques to reduce the risk of restenosis are also gaining popularity but the level of evidence remains weak. CONCLUSION Ext-DCR offers satisfactory clinical outcomes even though there are many gray areas that need to be addressed in future high-quality studies.
Collapse
Affiliation(s)
- Luca Giovanni Locatello
- Department of Otorhinolaryngology, Academic Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy
| | | | - Anna Tarantini
- Department of Medicine - Ophthalmology , University of Udine, Udine, Italy
| | - Paolo Lanzetta
- Department of Medicine - Ophthalmology , University of Udine, Udine, Italy
- Istituto Europeo di Microchirurgia Oculare (IEMO), Udine and Milan, Italy
- University of Udine, Department of Medicine (DAME), Via Colugna 50, 33100 Udine, Italy
| | - Cesare Miani
- Department of Otorhinolaryngology, Academic Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy
- University of Udine, Department of Medicine (DAME), Via Colugna 50, 33100 Udine, Italy
| |
Collapse
|
2
|
Huang IC, Wu HC, Lin CL, Wang HH. Development and Validation of the Osteoporosis Knowledge, Attitude, and Behaviors Questionnaire for Female Osteoporosis Patients in Taiwan: A Mediation Model. Healthcare (Basel) 2023; 11:healthcare11071023. [PMID: 37046950 PMCID: PMC10094534 DOI: 10.3390/healthcare11071023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/08/2023] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
This research develops the Osteoporosis Knowledge, Attitude and Behaviors Questionnaire (OKABQ) with the intent to evaluate the levels of osteoporosis knowledge, attitude and behavior change by developing and validating the OKABQ while establishing a mediation model of the research. A quantitative, descriptive and instrumental study was conducted in two phases: Phase I—development of the scale through Delphi Method by osteoporosis experts; and Phase II—evaluation of the validity and reliability of the scale and construction of a mediation model using SmartPLS. In Phase I, the content validity index (CVI) of the questionnaire was higher than 0.96 and the inter-rater reliability (IRR) kappa was 1.00. In Phase II, exploratory factor analysis showed that two predominating factors of attitude as a mediation were addressed by the 26-item OKABQ. The indirect effect results from the estimated model indicate that attitude mediates the relationship between knowledge and behaviors (β = 0.114, t = 2.627, p < 0.001), which is positive and statistically significant. We concluded that the OKABQ is a valid measure of osteoporosis knowledge, attitudes and behaviors for women with osteoporosis. These assessment results could assist healthcare providers in mitigating insufficiency in health education and help patients better adapt to a more active bone-healthy lifestyle.
Collapse
Affiliation(s)
- I-Chin Huang
- College of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Hui-Chuan Wu
- College of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chih-Lung Lin
- College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Hsiu-Hung Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| |
Collapse
|
3
|
Kaptı HB, Korkmaz H. Evaluation of the efficacy of postoperative triamcinolone in endoscopic dacryocystorhinostomy using lacrimal symptom questionnaire. Int Ophthalmol 2022; 42:2573-2580. [PMID: 35357636 DOI: 10.1007/s10792-022-02305-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 03/10/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the effect of postoperative nasal triamcinolone spray use in primary endoscopic dacryocystorhinostomy using The Lacrimal Symptom Questionnaire. METHODS This study included a series of 50 consecutive retrospective cases with primary endoscopic dacryocystorhinostomy and with silicone stent implantation who were followed up for 6 months postoperatively. Patients using nasal triamcinolone spray for 3 months postoperatively were included in the triamcinolone group. Patients not using triamcinolone were included in the control group. Lacrimal stents were removed 3 months postoperatively. The Lacrimal Symptom Questionnaire (Lac-Q) was performed in the preoperative and postoperative 6th month. Anatomical success, functional success, and changes in lacrimal symptom and social impact scores were compared between the two groups 6 months after surgery. RESULTS Results of 48 endoscopic dacryocystorhinostomies performed on 48 patients (23 triamcinolone group, 25 control group) meeting the inclusion criteria were analyzed. The anatomical success rate (95.7% vs. 84.0%, p = 0.350) and the functional success rate (91.3% vs. 76.0%, p = 0.249) were higher in the triamcinolone group, but this difference was not statistically significant. No complications were observed in the triamcinolone group, whereas complications developed in two patients in the control group (p = 0.490). The mean change in total lac-Q score was 11.0 in the triamcinolone group and 9.0 in the control group (p = 0.011). The mean change in social impact score was 4.0 in the triamcinolone group and 3.0 in the control group (p = 0.005). Mean change in lacrimal symptom score was 6.0 in the triamcinolone group and 6.0 in the control group (p = 0.368) CONCLUSIONS: Our study indicated that postoperative use of triamcinolone spray increases the success rate of endoscopic dacryocystorhinostomy and also revealed that triamcinolone may also lead to greater improvement in quality of life scores than the control group using a validated questionnaire.
Collapse
Affiliation(s)
| | - Hakan Korkmaz
- Department of Otorhinolaryngology, Faculty of Medicine, Ordu University, 52200, Ordu, Turkey
| |
Collapse
|
4
|
Purevdorj B, Dugarsuren U, Tuvaan B, Jamiyanjav B. Anatomy of lacrimal sac fossa affecting success rate in endoscopic and external dacryocystorhinostomy surgery in Mongolians. Anat Cell Biol 2021; 54:441-447. [PMID: 34620735 PMCID: PMC8693133 DOI: 10.5115/acb.21.081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 11/27/2022] Open
Abstract
To study the affect of anatomical variance of lacrimal sac fossa on dacryocystorhinostomies (DCR) performed by the traditional external (EX-DCR) approach or an endoscopic (EN-DCR) endonasal approach. A total of 292 consecutive cases with primary nasolacrimal obstruction underwent DCR surgery. Orbital computed tomography scan was used to measure lacrimal sac fossa and other related structures and Lac-Q questionnaire was used to compare surgery result. Maxillary portion of lacrimal sac fossa is thicker in failed surgery group than successful surgery group (P<0.05). Lateral nasal structures (uncinate process, operculum of the middle turbinate, agger nasi) are dominantly adjusting to lacrimal sac fossa in failed surgery group (P<0.05). Patients who underwent EX-DCR has a 6.0-point and EN-DCR group 11.0-point improvement (P<0.016) in Lac-Q questionnaire. Patients who have a thick frontal process of the maxilla and uncinate process, operculum of the middle turbinate, ethmoid cells adjusting to lacrimal fossa are prone to have recurrence of nasolacrimal duct obstruction after DCR surgery. The EN-DCR and the EX-DCR approach have an equivalent surgical success rate but improvement in quality of life by using the Lac-Q questionnaire is greater in the endoscopic group when compared with the external.
Collapse
Affiliation(s)
- Bayasgalan Purevdorj
- Department of Ophthalmology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Uranchimeg Dugarsuren
- Department of Anatomy, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Bulgan Tuvaan
- Department of Ophthalmology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Baasankhuu Jamiyanjav
- Department of Ophthalmology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| |
Collapse
|
5
|
Seo ST, Sundar G, Young SM. Postoperative Quality of Life in Oculoplastic Patients. Ophthalmic Plast Reconstr Surg 2021; 37:12-17. [PMID: 32358236 DOI: 10.1097/iop.0000000000001681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To conduct a literature review on postoperative quality of life in oculoplastic patients. METHODS The authors conducted a database search to evaluate the evidence available for the change in quality of life after oculoplastic surgery. RESULTS There was a wide disparity of evidence available for different oculoplastic conditions. Certain conditions, such as nasolacrimal duct obstruction, were well-researched while other conditions, such as epiblepharon, had little to no research supporting improvement in quality of life after surgery. The scales used to measure quality of life displayed heterogeneity. CONCLUSION There is a lack of published evidence concerning postoperative quality of life in patients with certain oculoplastic conditions such as brow ptosis, entropion, ectropion, epiblepharon, and orbital wall fracture. There is a need to standardize the quality of life data collection tools and scoring systems to allow better comparison and scrutiny of the current literature.
Collapse
Affiliation(s)
| | - Gangadhara Sundar
- Department of Ophthalmology, National University Hospital, Singapore
| | | |
Collapse
|
6
|
Allon R, Cohen O, Bavnik Y, Milstein A, Halperin D, Warman M. Long-term Outcomes for Revision Endoscopic Dacryocystorhinostomy-The Effect of the Primary Approach. Laryngoscope 2020; 131:E682-E688. [PMID: 32521057 DOI: 10.1002/lary.28795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/10/2020] [Accepted: 05/14/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS Revision endoscopic dacryocystorhinostomy (END-DCR) is the preferred approach for failed primary surgeries, yet quality data on long-term outcomes are lacking. This study aimed to evaluate three aspects of revision END-DCR: 5-year success rates, patient satisfaction, and the primary surgical approach's possible impact on revision. METHODS This retrospective study included all revision END-DCRs conducted at Kaplan Medical Center between the years 2002 and 2015. For long-term follow-up analysis, two subgroups of first and second revision END-DCRs with a minimum of documented 5-year follow-up after surgery were defined. Data were analyzed according to the primary surgical approach. Surgical success was defined by either anatomical (observed patent lacrimal flow) or functional (symptoms cessation) success. Patient satisfaction was measured by a questionnaire. RESULTS After exclusions, a total of 45 eyes from 38 patients who underwent revision END-DCR surgeries were included in the study. The yearly success rates from immediate to 5 years following the first revision were 93.3%, 75.5%, 71.1%, 68.9%, 68.9%, and 68.9% for the entire cohort, respectively. Immediate and 5-year success rates following the second revision were 88.8% and 77.8%, respectively. Primary END-DCR showed favorable 5-year success rates and patient satisfaction over primary external dacryocystorhinostomy (EXT-DCR) in both first and second revisions, but this did not reach significance. CONCLUSIONS Revision END-DCR carries an excellent short-term success rate, which decreases mainly throughout the first 2 years following surgery. Postoperative follow-up should be maintained within this timeframe. Revision END-DCR following either primary endoscopic or EXT-DCR produces comparable surgical outcomes and patient-reported satisfaction. LEVEL OF EVIDENCE 3b Laryngoscope, 131:E682-E688, 2021.
Collapse
Affiliation(s)
- Raviv Allon
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Oded Cohen
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Yosef Bavnik
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Asher Milstein
- Hadassah Medical School, Hebrew University, Jerusalem, Israel.,Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel
| | - Doron Halperin
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Meir Warman
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, Hebrew University, Jerusalem, Israel
| |
Collapse
|
7
|
Herzallah IR, Marglani OA, Alherabi AZ, Faraj NS, Bukhari DH. Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients. Int Arch Otorhinolaryngol 2019; 23:191-195. [PMID: 30956704 PMCID: PMC6449129 DOI: 10.1055/s-0038-1675394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 09/02/2018] [Indexed: 12/27/2022] Open
Abstract
Introduction
Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting.
Objective
To evaluate the feasibility and the outcome of simultaneous bilateral Endo-DCR and its impact on the quality of life of the patients.
Methods
We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire.
Results
Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37.
Conclusion
Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients.
Collapse
Affiliation(s)
- Islam R Herzallah
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia
| | - Osama A Marglani
- Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia.,Department of Ophthalmology & Otolaryngology, Umm Al-Qura University, KSA, Makkah, Saudi Arabia
| | - Ameen Z Alherabi
- Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia.,Department of Ophthalmology & Otolaryngology, Umm Al-Qura University, KSA, Makkah, Saudi Arabia
| | - Nuha S Faraj
- Department of Ophthalmology & Otolaryngology, Umm Al-Qura University, KSA, Makkah, Saudi Arabia
| | - Deemah H Bukhari
- Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia
| |
Collapse
|