Background: The aim of this study was to describe the efficiency, long-term success, patient satisfaction and recurrence rate after dacryocystorhinostomy according to Toti in a retrospective analysis.
Material And Methods: At the Eye Clinic of the Paracelsus Medical University Salzburg 188 eyes of 176 patients with stenosis/obstruction of lacrimal duct were surgically treated between January 2000 and December 2012. Of these patients 173 eyes had no surgery before DCR according to Toti and 15 eyes had already been operated with diverse dacryocystorhinostomies. All patients underwent dacryocystorhinostomy according to Toti. Pre- and postoperative clinical finings were analysed retrospectively. Postoperative long-term results regarding patient satisfaction, absence of inflammation, epiphora and annoyance through local scar building had been evaluated with a questionnaire in a cross-sectional analysis.
Results: The primary success rate of DCR according to Toti was 91,9 % and the secondary success rate 98,3 % in patients without surgery preoperatively. Classifying by localisation of stenosis, better results could be reached in patients with postsaccal stenosis/obstructions (94,3 %) than in those with presaccal obstructions (77,8 %) or with mixed pre- and postsaccal stenosis/obstructions (86,7 %). Also in the patient group with previous surgery primary and secondary success rates of 93,3 % could be achieved after DCR according to Toti.
Conclusions: This study confirms that DCR according to Toti is a highly successful technique minimising epiphora and discomfort. The best success rate was found in patients with postsaccal stenosis/obstructions. The local scar was not found to be disturbing.
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http://dx.doi.org/10.1055/s-0033-1360358 | DOI Listing |
Cureus
December 2024
Department of Otorhinolaryngology, Medical University of Plovdiv, Plovdiv, BGR.
Background Dacryocystitis (DC) is a disease most often caused by an obstruction of the nasolacrimal duct, leading to over-accumulation of tears in the lacrimal sac, epiphora, and aseptic inflammation. External and endoscopic dacryocystorhinostomy (DCR) aims to restore the tear pathway by creating a bypass from the lacrimal sac to the nose. The aim of this study is to investigate superior nasal septal deviation as a possible contributing factor in the incidence and treatment of dacryocystitis.
View Article and Find Full Text PDFSemin Ophthalmol
January 2024
Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India.
Klin Monbl Augenheilkd
September 2017
Epiphora is one of the most common symptoms for clinical ophthalmological consultation. This symptom is mostly caused by stenosis of the lacrimal drainage system. Over a century, external dacryocystostomy according to Toti was the treatment of choice.
View Article and Find Full Text PDFHNO
June 2016
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Straße 137-139, 18057, Rostock, Deutschland.
Background: Epiphora is the classic symptom of nasolacrimal duct obstruction, particularly among elderly people. Dacryocystorhinostomy (DCR) via external (Toti) and endonasal (West) approaches are well-established surgical treatments.
Objective: The aim of the present article is to describe the etiology and diagnostics of nasolacrimal duct obstruction.
Ophthalmologe
February 2015
Zentrum für Augenheilkunde, Universitätsklinikum Köln, 50924, Köln, Deutschland,
For the treatment of postsaccal lacrimal drainage obstructions transcanalicular laser dacryocystorhinostomy (TCL-DCR) represents a less invasive alternative to external Toti procedures. Herein, a diode laser optical fiber is inserted into the lacrimal sac via the canaliculi. Under visual control with a nasal endoscope laser energy is applied until a patent osteotomy between the sac and nasal mucosa has been created.
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