A critical update on endoscopic dacryocystorhinostomy.

IF 2.1 4区医学 Q2 OTORHINOLARYNGOLOGY Acta Otorhinolaryngologica Italica Pub Date : 2024-12-01 DOI:10.14639/0392-100X-N2916

Luca Giovanni Locatello, Enrico Redolfi De Zan, Nicole Caiazza, Anna Tarantini, Paolo Lanzetta, Cesare Miani

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Abstract

Objectives: Endoscopic dacryocystorhinostomy (endo-DCR) is becoming a workhorse in the management of distal lacrimal duct obstruction. It yields success rates comparable to external DCR, with the advantage of no external scars. However, it requires multidisciplinary expertise and many uncertainties in terms of proper indications, technique, and perioperative management still exist.

Methods: Systematic review of the literature in the last 5 years using PubMed and Google Scholar.

Results: A total of 66 articles were included. Many technical modifications and surgical refinements have been proposed, but a formal comparison of the various techniques is hampered by methodological heterogeneity. The use of local anaesthesia and perioperative adjunctive techniques to reduce the risk of restenosis are also gaining popularity even if the level of evidence remains weak.

Conclusions: Endo-DCR offers satisfactory clinical outcomes even though there are many grey areas that need to be addressed in future high-quality studies.

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内窥镜泪囊鼻腔造口术的重要进展。

目的：内镜下泪囊鼻腔造瘘术（endod - dcr）正在成为治疗远端泪管阻塞的主要方法。它的成功率与外部DCR相当，具有无外部疤痕的优势。然而，它需要多学科的专业知识，在适当的适应症、技术和围手术期管理方面仍然存在许多不确定性。方法：利用PubMed和谷歌Scholar对近5年的文献进行系统综述。结果：共纳入66篇文献。已经提出了许多技术修改和手术改进，但由于方法的异质性，各种技术的正式比较受到阻碍。使用局部麻醉和围手术期辅助技术来减少再狭窄的风险也越来越受欢迎，即使证据水平仍然薄弱。结论：Endo-DCR提供了令人满意的临床结果，尽管在未来的高质量研究中存在许多需要解决的灰色地带。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Otorhinolaryngologica Italica OTORHINOLARYNGOLOGY-

CiteScore

3.40

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Acta Otorhinolaryngologica Italica first appeared as “Annali di Laringologia Otologia e Faringologia” and was founded in 1901 by Giulio Masini. It is the official publication of the Italian Hospital Otology Association (A.O.O.I.) and, since 1976, also of the Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale (S.I.O.Ch.C.-F.). The journal publishes original articles (clinical trials, cohort studies, case-control studies, cross-sectional surveys, and diagnostic test assessments) of interest in the field of otorhinolaryngology as well as clinical techniques and technology (a short report of unique or original methods for surgical techniques, medical management or new devices or technology), editorials (including editorial guests – special contribution) and letters to the Editor-in-Chief. Articles concerning science investigations and well prepared systematic reviews (including meta-analyses) on themes related to basic science, clinical otorhinolaryngology and head and neck surgery have high priority.