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Endoscopic dacryocystorhinostomy as treatment for lower lacrimal pathway obstructions in adults: Review article.

Penttilä E, Smirnov G, Tuomilehto H, Kaarniranta K, Seppä J - Allergy Rhinol (Providence) (2015)

Bottom Line: Conservative treatments only achieve temporary relief of symptoms, thus surgery is the treatment of choice.The aim of this operation is to create a bypass between the lacrimal sac and the nasal cavity.This article reviews the published literature about the technical issues associated with the success of EN-DCR, and clarifies the pros and cons of different pre- and postoperative procedures in adults with lower lacrimal pathway obstructions.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, and University of Eastern Finland, and Kuopio University Hospital, Finland.

ABSTRACT
Obstruction of the lacrimal pathway is manifested by epiphora, infection, and blurred vision as well as ocular and facial pain. Conservative treatments only achieve temporary relief of symptoms, thus surgery is the treatment of choice. Dacryocystorhinostomy (DCR) is recognized as the most suitable treatment for patients with obstructions of the lacrimal system at the level of the sac or in the nasolacrimal duct. The aim of this operation is to create a bypass between the lacrimal sac and the nasal cavity. During the past 2 decades, advances in rigid endoscopic equipment and other instruments have made it possible to obtain more information about the anatomic landmarks of the nasolacrimal system, which led to the development of less-invasive and safer endoscopic techniques. However, many parts of the treatment process related to endoscopic endonasal dacryocystorhinostomy (EN-DCR) still remain controversial. This article reviews the published literature about the technical issues associated with the success of EN-DCR, and clarifies the pros and cons of different pre- and postoperative procedures in adults with lower lacrimal pathway obstructions.

No MeSH data available.


Related in: MedlinePlus

Anatomy of the nasolacrimal system: 1, lacrimal gland; 2, punctal openings; 3, inferior canaliculus; 4, superior canaliculus; 5, common canaliculus; 6, lacrimal sac; 7, nasolacrimal duct; 8, uncinate process; 9, middle turbinate; 10, inferior turbinate.
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Figure 1: Anatomy of the nasolacrimal system: 1, lacrimal gland; 2, punctal openings; 3, inferior canaliculus; 4, superior canaliculus; 5, common canaliculus; 6, lacrimal sac; 7, nasolacrimal duct; 8, uncinate process; 9, middle turbinate; 10, inferior turbinate.

Mentions: The system that secretes and drains tears into the nasal cavity consists of the lacrimal gland in conjunction with the upper and the lower lacrimal pathways (Fig. 1). The upper lacrimal pathway is made up of the puncta and lacrimal canaliculi, whereas the lower lacrimal pathway contains the lacrimal sac and nasolacrimal duct.


Endoscopic dacryocystorhinostomy as treatment for lower lacrimal pathway obstructions in adults: Review article.

Penttilä E, Smirnov G, Tuomilehto H, Kaarniranta K, Seppä J - Allergy Rhinol (Providence) (2015)

Anatomy of the nasolacrimal system: 1, lacrimal gland; 2, punctal openings; 3, inferior canaliculus; 4, superior canaliculus; 5, common canaliculus; 6, lacrimal sac; 7, nasolacrimal duct; 8, uncinate process; 9, middle turbinate; 10, inferior turbinate.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388871&req=5

Figure 1: Anatomy of the nasolacrimal system: 1, lacrimal gland; 2, punctal openings; 3, inferior canaliculus; 4, superior canaliculus; 5, common canaliculus; 6, lacrimal sac; 7, nasolacrimal duct; 8, uncinate process; 9, middle turbinate; 10, inferior turbinate.
Mentions: The system that secretes and drains tears into the nasal cavity consists of the lacrimal gland in conjunction with the upper and the lower lacrimal pathways (Fig. 1). The upper lacrimal pathway is made up of the puncta and lacrimal canaliculi, whereas the lower lacrimal pathway contains the lacrimal sac and nasolacrimal duct.

Bottom Line: Conservative treatments only achieve temporary relief of symptoms, thus surgery is the treatment of choice.The aim of this operation is to create a bypass between the lacrimal sac and the nasal cavity.This article reviews the published literature about the technical issues associated with the success of EN-DCR, and clarifies the pros and cons of different pre- and postoperative procedures in adults with lower lacrimal pathway obstructions.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, and University of Eastern Finland, and Kuopio University Hospital, Finland.

ABSTRACT
Obstruction of the lacrimal pathway is manifested by epiphora, infection, and blurred vision as well as ocular and facial pain. Conservative treatments only achieve temporary relief of symptoms, thus surgery is the treatment of choice. Dacryocystorhinostomy (DCR) is recognized as the most suitable treatment for patients with obstructions of the lacrimal system at the level of the sac or in the nasolacrimal duct. The aim of this operation is to create a bypass between the lacrimal sac and the nasal cavity. During the past 2 decades, advances in rigid endoscopic equipment and other instruments have made it possible to obtain more information about the anatomic landmarks of the nasolacrimal system, which led to the development of less-invasive and safer endoscopic techniques. However, many parts of the treatment process related to endoscopic endonasal dacryocystorhinostomy (EN-DCR) still remain controversial. This article reviews the published literature about the technical issues associated with the success of EN-DCR, and clarifies the pros and cons of different pre- and postoperative procedures in adults with lower lacrimal pathway obstructions.

No MeSH data available.


Related in: MedlinePlus