Nazolakrimal kanal tıkanıklığı tedavisinde sadece ön flep sütürasyonlu eksternal dakriyosistorinostominin uzun dönem sonuçları
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Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Nazolakrimal kanal tıkanıklığı (NLKT), gözyaşı drenajını bozarak göz sağlığını ve sosyal hayatı olumsuz etkileyen önemli bir hastalıktır. Tüm yaş gruplarında görülebilir. Erişkinlerde tedavisi için ilk ve en başarılı seçenek dakriyosistorinostomi (DSR) ameliyatıdır. Bu retrospektif çalışmada klasik DSR cerrahisinin bir modifikasyonu olan sadece ön fleplerin sütüre edildiği eksternal DSR ameliyatının uzun dönem sonuçlarını bildirmek amaçlandı. Çalışmaya sadece ön flep sütürasyonlu eksternal DSR ameliyatı yapılan 139 hastanın 154 gözü dahil edildi. 98 kadına (%70.5) ait108 göz (%70.1), 39 erkeğe (%29.5) ait 46 göz (%29.9) incelendi. Gözlerin 85'i sağ (%55.2), 69'u sol (%44.8) idi. Hastaların yaş ortalaması 48.1±14.4 idi (Kadınlarda 47.8±13.6, erkeklerde 49.0±16.5). Kadın hasta sayısı anlamlı olarak yüksekti ancak iki cinsiyetin yaş ortalaması benzer bulundu (p=0.663, p>0.05). Takip süresi minimum 6 ay olup ortalama 81.3±46.8 aydı. Takip süresi sonunda uygulanan cerrahi metodun anatomik başarı oranı %92.9, fonksiyonel başarı oranı %86.4 olarak bulundu. Cerrahi esnasında silikon tüp entübasyonu yapılan 53 gözde (%34.4) fonksiyonel başarı oranı %86.8 (46 göz), anatomik başarı oranı %92.5 (49 göz) olup silikon tüp entübasyonu yapılmayan grupla aralarında istatistiksel olarak anlamlı fark saptanmadı (sırasıyla p=0.561, p>0.05; p=0.562, p>0.05). Toplamda 5 gözde (%3.2) skar şikayeti mevcuttu. Sonuç olarak sadece ön fleplerin sütüre edildiği DSR ameliyatının başarı oranları literatür ile uyumlu olarak yüksek olarak bulunmuştur. Geniş bir vaka serisinde ilk kez bu kadar uzun dönem sonuçlarının tarafımızca bildirilmesinin bu cerrahi modifikasyonu destekleyen bir veri olarak literatüre katkı sağlayacağı ve tercih edecek olanlara yol göstereceği kanaatindeyiz. Anahtar kelimeler: Epifora, nazolakrimal kanal tıkanıklığı, eksternal dakriyosistorinostomi, sadece ön flep sütürasyonu
Nasolacrimal duct obstruction (NLDO) is an important disease that negatively affects eye health and social life by disrupting tear drainage. It can be seen in all age groups. The first and most successful option for treatment in adults is dacryocystorhinostomy (DCR) surgery. In this retrospective study, it was aimed to report the long-term results of external DCR surgery, which is a modification of classical DCR surgery, in which only anterior flaps are sutured. A total of 154 eyes of 139 patients who underwent external DCR surgery with only anterior flap suturing were included in the study. 108 eyes (70.1%) of 98 women (70.5%) and 46 eyes (29.9%) of 39 men (29.5%) were examined. Eighty-five eyes (55.2%) were right and 69 were left (44.8%). The mean age of the patients was 48.1±14.4 (47.8±13.6 in females, 49.0±16.5 in males). The number of female patients was significantly higher, but the mean age of the two sexes was similar (p=0.663, p>0.05). The follow-up period was a minimum of 6 months, with a mean of 81.3±46.8 months. The anatomical success rate of the surgical method applied at the end of the follow-up period was 92.9%, and the functional success rate was 86.4%. In 53 eyes (34.4%) who underwent silicone tube intubation during surgery, the functional success rate was 86.8% (46 eyes), the anatomical success rate was 92.5% (49 eyes), and there was no statistically significant difference between the group without silicone tube intubation (p=0.561, p, respectively). >0.05; p=0.562, p>0.05). There were scar complaints in 5 eyes (3.2%) in total. As a result, the success rates of DCR surgery, in which only the anterior flaps are sutured, were found to be high in line with the literature. We believe that our report of such long-term results for the first time in a large case series will contribute to the literature as a data supporting this surgical modification and will guide those who will prefer it. Keywords: Epiphora, nasolacrimal duct obstruction, external dacryocystorhinostomy, only anterior flap suturing
Nasolacrimal duct obstruction (NLDO) is an important disease that negatively affects eye health and social life by disrupting tear drainage. It can be seen in all age groups. The first and most successful option for treatment in adults is dacryocystorhinostomy (DCR) surgery. In this retrospective study, it was aimed to report the long-term results of external DCR surgery, which is a modification of classical DCR surgery, in which only anterior flaps are sutured. A total of 154 eyes of 139 patients who underwent external DCR surgery with only anterior flap suturing were included in the study. 108 eyes (70.1%) of 98 women (70.5%) and 46 eyes (29.9%) of 39 men (29.5%) were examined. Eighty-five eyes (55.2%) were right and 69 were left (44.8%). The mean age of the patients was 48.1±14.4 (47.8±13.6 in females, 49.0±16.5 in males). The number of female patients was significantly higher, but the mean age of the two sexes was similar (p=0.663, p>0.05). The follow-up period was a minimum of 6 months, with a mean of 81.3±46.8 months. The anatomical success rate of the surgical method applied at the end of the follow-up period was 92.9%, and the functional success rate was 86.4%. In 53 eyes (34.4%) who underwent silicone tube intubation during surgery, the functional success rate was 86.8% (46 eyes), the anatomical success rate was 92.5% (49 eyes), and there was no statistically significant difference between the group without silicone tube intubation (p=0.561, p, respectively). >0.05; p=0.562, p>0.05). There were scar complaints in 5 eyes (3.2%) in total. As a result, the success rates of DCR surgery, in which only the anterior flaps are sutured, were found to be high in line with the literature. We believe that our report of such long-term results for the first time in a large case series will contribute to the literature as a data supporting this surgical modification and will guide those who will prefer it. Keywords: Epiphora, nasolacrimal duct obstruction, external dacryocystorhinostomy, only anterior flap suturing
Açıklama
Anahtar Kelimeler
Göz Hastalıkları, Eye Diseases
