Probing versus primary nasal endoscopy for the treatment of congenital dacryocystoceles

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-04-01 DOI:10.1016/j.jaapos.2024.103865
Tessnim R. Ahmad MD , Karla J. Lindquist PhD , Julius T. Oatts MD , Alejandra G. de Alba Campomanes MD, MPH , Robert C. Kersten MD , Dylan K. Chan MD, PhD , Maanasa Indaram MD
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Abstract

Purpose

To compare outcomes and complications of three surgical techniques for the treatment of congenital dacryocystoceles: nasolacrimal probing and irrigation (P+I), P+I plus nasal endoscopy (NE) with intranasal cyst marsupialization, and primary NE with intranasal cyst marsupialization.

Methods

The medical records of children ≤2 years of age at a single academic center with a diagnosis of dacryocystocele from 2012 to 2022 were retrospectively identified and reviewed. The primary outcome was resolution of the dacryocystocele (ie, elimination of the medial canthal mass and resolution of tearing or discharge) after a single procedure (“primary success”). Surgical techniques were compared using exact logistic regression.

Results

Of 54 patients, 21 (39%) underwent P+I, 23 (43%) underwent P+I plus nasal endoscopy, and 10 (18%) underwent primary NE. Primary success was 76% for P+I and 100% for the other two cohorts. Most patients (89%) who underwent P+I received general anesthesia compared with none who underwent primary nasal endoscopy. Most complications were related to the use of general anesthesia, with a complication rate of 10% for P+I, 48% for P+I plus NE, and 0% for primary NE. Most P+I procedures required hospital admission compared to half of primary NE procedures.

Conclusions

In our study cohort, primary NE provided good outcomes and was associated with a lower complication rate than P+I with or without NE.

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在治疗先天性泪囊炎方面,鼻内窥镜探查术与鼻内窥镜初探术的比较。
目的:比较治疗先天性泪囊炎的三种手术方法的疗效和并发症:鼻泪管探查和冲洗术(P+I)、鼻泪管探查和冲洗术加鼻内窥镜检查(NE)加鼻内囊肿填塞术、原发性NE加鼻内囊肿填塞术:方法: 对一家学术中心 2012 年至 2022 年诊断为泪囊肿的 2 岁以下儿童的病历进行回顾性识别和审查。主要结果是单次手术后泪囊消失(即内侧泪囊肿块消失、撕裂或分泌物消失)("主要成功")。采用精确的逻辑回归对手术技术进行了比较:在 54 名患者中,21 人(39%)接受了 P+I,23 人(43%)接受了 P+I 加鼻内窥镜检查,10 人(18%)接受了初级 NE。P+I的初治成功率为76%,其他两组患者的初治成功率为100%。大多数接受 P+I 的患者(89%)都接受了全身麻醉,而接受初级鼻内窥镜检查的患者则无一接受全身麻醉。大多数并发症与使用全身麻醉有关,P+I并发症发生率为10%,P+I加鼻内镜并发症发生率为48%,原发性鼻内镜并发症发生率为0%。大多数 P+I 手术需要入院治疗,而初级 NE 手术只有一半需要入院治疗:结论:在我们的研究队列中,与有或没有NE的P+I相比,初级NE能提供良好的治疗效果,并发症发生率也较低。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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