Five- and 10-Year Outcomes for Primary Endoscopic Dacryocystorhinostomy: Failure Rate and Risk Factors.


Journal

The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378

Informations de publication

Date de publication:
01 2021
Historique:
received: 25 11 2019
revised: 30 12 2019
accepted: 06 01 2020
pubmed: 6 2 2020
medline: 20 1 2021
entrez: 4 2 2020
Statut: ppublish

Résumé

Endoscopic dacryocystorhinostomy (eDCR) is the preferred approach for nasolacrimal duct obstruction, yet quality data on long-term outcomes is lacking. A retrospective study in a single, academic institution. To assess the 5- and 10-year success rates of eDCR, and its associated risks. All eDCRs conducted at Kaplan Medical Center between the years 2002-2017 were included. For long-term follow-up analysis, two subgroups with a minimum of documented 5- and 10-year follow-up after surgery were defined. Surgical success was defined by both anatomical (observed patent lacrimal flow) and functional (symptomatic relief) success. Data was collected from the hospital's electronic medical records and was completed by phone interviews. Pre-, intra-, and postoperative variables were collected and stratified by multivariate analysis. After exclusions, 321, 168, and 65 patients were included for immediate, 5- and 10-year outcome analysis, respectively. Overall success rates were 92.5%, 86.3%, and 80%, respectively. The anatomical success rates were 93.8%, 89.9%, and 86.1%, respectively. Multivariate analysis revealed that older age (P < .001, P = .001) previous smoking (P = .043, P = .037), and postoperative complains of epiphora (even when a successful irrigation was observed, P < .001, P = .01) were all associated with eDCR failure 5 and 10 years following surgery. Male gender was also associated with eDCR failure (5 years, P = .045; 10 years, P = .063). Despite decreased rates over time, eDCR is beneficial for the majority of patients also at 10 years following surgery. Older age, smoking, postoperative epiphora, and male gender are related to long-term failure and should be discussed with the patients before surgery. 3b Laryngoscope, 131:10-16, 2021.

Identifiants

pubmed: 32011002
doi: 10.1002/lary.28528
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

10-16

Informations de copyright

© 2020 The American Laryngological, Rhinological and Otological Society, Inc.

Références

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Auteurs

Oded Cohen (O)

Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
Hadassah Medical School, Hebrew University, Jerusalem, Israel.

Itai Amos (I)

Hadassah Medical School, Hebrew University, Jerusalem, Israel.

Doron Halperin (D)

Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
Hadassah Medical School, Hebrew University, Jerusalem, Israel.

Yosef Bavnik (Y)

Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
Hadassah Medical School, Hebrew University, Jerusalem, Israel.

Asher Milstein (A)

Hadassah Medical School, Hebrew University, Jerusalem, Israel.
Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel.

Yochai Shoshani (Y)

Hadassah Medical School, Hebrew University, Jerusalem, Israel.
Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel.

Hana Leiba (H)

Hadassah Medical School, Hebrew University, Jerusalem, Israel.
Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel.

Meir Warman (M)

Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
Hadassah Medical School, Hebrew University, Jerusalem, Israel.

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