Dacryocystorhinostomy With and Without Silicone Stent: Is There Any Significant Difference into the Outcomes?

Abstract

Aim: To compare the difference between the outcomes of endonasal endoscopic dacryocystorhinostomy (En-DCR) with and without silcone tube intubation (stent) for treatment of primary dacryocystitis and phlegmonus dacryocystitis. Method: A hospital based retrospective comparative study of 111 subjects operated for dacryocystitis between October 2014 to May 2021 were analyzed, of which 60 were with silicone stent and 51 were without silicone stent. Silicone tubes were kept in the lacrimal passages for 3 months. In this study we compare the surgery follow up from 3 to 6 months and the complication after each surgery. Surgery was defined as a functional success when there was no evidence of postoperative epiphora, purulent secretions, infection, granuloma, recurrence of dacryocystitis observed upon endonasal endoscopic evaluation. Results: A total of 111 consecutive endoscopic transnasal dacryocystorhinostomy procedures performed at American Hospital 1 of Tirana between October 2014 and May 2021 were reviewed. Of the 111 patients with acute dacryocystitis, 60 (54.05%) were treated with silicone stent (group A) and 51 (45.94%) were treated without silicone stent (group B). 20 of 111 (18%) were diagnosed with phlegmonous dacryocystitis of wich 7 (11.67%) were part of group A and 13 (25.49%) were part of group B. On six months of surgery all the patients were followed up. Only 7 patients (11.66%) in the group A had complications such us purulent secretions (2 or 28.57%), infection (3 or 42.85%), epiphora (1 or 14.28%), granuloma (1 or 14.28%) and none in the group B had any of them. No complications were encountered in patients with phlegmonous dacryocystitis. Conclusion: Dacryocystorhinostomy with silicone tube intubation and without silicon tube intubation are two different procedures without any significant difference in the rate of success. In the light of differences in its complications this study supports the routine without silicone stent of acute dacryocystitis and phlegmonous dacryocystitis patients following En-DCR surgery, suggesting that stents are not necessary for primary DCRs.

Received: 26 September 2022 / Accepted: 27 November 2022 / Published: 20 December 2022