Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients

Islam R. Herzallah; Osama A. Marglani; Ameen Z. Alherabi; Nuha S. Faraj; Deemah H. Bukhari

doi:10.1055/s-0038-1675394

International Archives of Otorhinolaryngology, Table of Contents

CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2019; 23(02): 191-195
DOI: 10.1055/s-0038-1675394

Original Research

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients

Islam R. Herzallah

¹Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

²Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia

,

Osama A. Marglani

²Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia

³Department of Ophthalmology & Otolaryngology, Umm Al-Qura University, KSA, Makkah, Saudi Arabia

,

Ameen Z. Alherabi

²Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia

³Department of Ophthalmology & Otolaryngology, Umm Al-Qura University, KSA, Makkah, Saudi Arabia

,

Nuha S. Faraj

³Department of Ophthalmology & Otolaryngology, Umm Al-Qura University, KSA, Makkah, Saudi Arabia

,

Deemah H. Bukhari

²Ear Nose and Throat Department, Head and Neck and Skull Base Center, King Abdullah Medical City (KAMC-HC), KSA, Makkah, Saudi Arabia

› Author Affiliations

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.

Keywords

dacryocystorhinostomy - epiphora - dacryocystitis - nasolacrimal duct - lacrimal sac - quality of life - endoscopic DCR

Full Text

References

References
1 Onerci M. Dacryocystorhinostomy. Diagnosis and treatment of nasolacrimal canal obstructions. Rhinology 2002; 40 (02) 49-65
2 Giasin O, Yeo DC, Aguirre A. Just how old is the modern dacrocystorhinostomy?. Br J Ophthalmol 2014; 98 (08) 1134-1135
3 Penttilä E, Smirnov G, Tuomilehto H, Kaarniranta K, Seppä J. Endoscopic dacryocystorhinostomy as treatment for lower lacrimal pathway obstructions in adults: Review article. Allergy Rhinol (Providence) 2015; 6 (01) 12-19
4 Knisely A, Harvey R, Sacks R. Long-term outcomes in endoscopic dacryocystorhinostomy. Curr Opin Otolaryngol Head Neck Surg 2015; 23 (01) 53-58
5 Ali MJ, Psaltis AJ, Murphy J, Wormald PJ. Outcomes in primary powered endoscopic dacryocystorhinostomy: comparison between experienced versus less experienced surgeons. Am J Rhinol Allergy 2014; 28 (06) 514-516
6 Marcet MM, Kuk AK, Phelps PO. Evidence-based review of surgical practices in endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction and other new indications. Curr Opin Ophthalmol 2014; 25 (05) 443-448
7 Ali MJ, Joshi SD, Naik MN, Honavar SG. Clinical profile and management outcome of acute dacryocystitis: two decades of experience in a tertiary eye care center. Semin Ophthalmol 2015; 30 (02) 118-123
8 Yuksel D, Kosker M, Akoz I, Simsek S. Long-term results of simultaneous bilateral external dacryocystorhinostomy in cases with bilateral dacryostenosis. Semin Ophthalmol 2015; 30 (01) 20-24
9 Bayraktar C, Karadağ AS, Doğan S, Şimşek A, Kaskalan E, Çapkin M. Simultaneous Bilateral Endonasal Endoscopic Dacryocystorhinostomy: A Low Cost, Fast, and Successful Method. J Craniofac Surg 2016; 27 (08) e726-e728
10 Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000; 85 (01) 109-117
11 Yeniad B, Uludag G, Kozer-Bilgin L. Assessment of patient satisfaction following external versus transcanalicular dacryocystorhinostomy with a diode laser and evaluation if change in quality of life after simultaneous bilateral surgery in patients with bilateral nasolacrimal duct obstruction. Curr Eye Res 2012; 37 (04) 286-292
12 Chung JK, Park SH, Lee WJ, Lee SJ. Bilateral cataract surgery: a controlled clinical trial. Jpn J Ophthalmol 2009; 53 (02) 107-113
13 Smirnov G, Tuomilehto H, Kokki H. , et al. Symptom score questionnaire for nasolacrimal duct obstruction in adults--a novel tool to assess the outcome after endoscopic dacryocystorhinostomy. Rhinology 2010; 48 (04) 446-451
14 Penttila E, Smirnov G, Seppa J, Tuomilehto H, Kokki H. Validation of a symptom-score questionnaire and long- term results of endoscopic dacryocystorhinostomy. Rhinology 2014; 52 (01) 84-89
15 Robinson K, Gatehouse S, Browning GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 1996; 105 (06) 415-422
16 Ianovski I, Morton RP, Ahmad Z. Patient-perceived outcome after sialendoscopy using the glasgow benefit inventory. Laryngoscope 2014; 124 (04) 869-874
17 Hendry J, Chin A, Swan IR, Akeroyd MA, Browning GG. The Glasgow Benefit Inventory: a systematic review of the use and value of an otorhinolaryngological generic patient-recorded outcome measure. Clin Otolaryngol 2016; 41 (03) 259-275
18 Dutt SN, McDermott AL, Jelbert A, Reid AP, Proops DW. The Glasgow benefit inventory in the evaluation of patient satisfaction with the bone-anchored hearing aid: quality of life issues. J Laryngol Otol Suppl 2002; (28) 7-14
19 Ho A, Sachidananda R, Carrie S, Neoh C. Quality of life assessment after non-laser endonasal dacryocystorhinostomy. Clin Otolaryngol 2006; 31 (05) 399-403
20 Spielmann PM, Hathorn I, Ahsan F, Cain AJ, White PS. The impact of endonasal dacryocystorhinostomy (DCR), on patient health status as assessed by the Glasgow benefit inventory. Rhinology 2009; 47 (01) 48-50
21 Bakri SJ, Carney AS, Robinson K, Jones NS, Downes RN. Quality of life outcomes following dacryocystorhinostomy: external and endonasal laser techniques compared. Orbit 1999; 18 (02) 83-88
22 Jutley G, Karim R, Joharatnam N, Latif S, Lynch T, Olver JM. Patient satisfaction following endoscopic endonasal dacryocystorhinostomy: a quality of life study. Eye (Lond) 2013; 27 (09) 1084-1089
23 Ali MJ, Iram S, Ali MH, Naik MN. Assessing the Outcomes of Powered Endoscopic Dacryocystorhinostomy in Adults Using the Lacrimal Symptom (Lac-Q) Questionnaire. Ophthal Plast Reconstr Surg 2017; 33 (01) 65-68
24 Wong WK, Dean S, Nair S. Comparison between endoscopic and external dacryocystorhinostomy by using the Lacrimal Symptom Questionnaire: A pilot study. Am J Rhinol Allergy 2018; 32 (01) 46-51
25 Sprekelsen MB, Barberán MT. Endoscopic dacryocystorhinostomy: surgical technique and results. Laryngoscope 1996; 106 (2 Pt 1): 187-189
26 Herzallah I, Alzuraiqi B, Bawazeer N. , et al. Endoscopic Dacryocystorhinostomy (DCR): a comparative study between powered and non-powered technique. J Otolaryngol Head Neck Surg 2015; 44: 56
27 Tanigawa T, Sasaki H, Nonoyama H. , et al. Outcomes of endoscopic endonasal dacryocystorhinostomy for intractable lacrimal dacryostenosis and associated factors. Int J Ophthalmol 2016; 9 (10) 1471-1475
28 Krings JG, Kallogjeri D, Wineland A, Nepple KG, Piccirillo JF, Getz AE. Complications of primary and revision functional endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope. 2014; 124 (04) 838-845
29 Yang JW, Oh HN. Success rate and complications of endonasal dacryocystorhinostomy with unciformectomy. Graefes Arch Clin Exp Ophthalmol 2012; 250 (10) 1509-1513
30 Bayraktar C, Şimşek A. Increased Concomitant Nasal Procedure Frequency in Bilateral Endoscopic Dacryocystorhinostomy. J Craniofac Surg 2017; 28 (04) 980-982