Clinical Observation of External Dacryocystorhinostomy.

Lee, Byoung Suck

Original Article

Journal of the Korean Ophthalmological Society 1979;20(3):291-297.
Published online March 1, 1979.

Clinical Observation of External Dacryocystorhinostomy.

Byoung Suck Lee

Department of Ophthalmology, College of Medicine, Korea University, Seoul, Korea.

누낭비강문합술의 (淚囊鼻腔吻合術) 임상적 고찰

이병석 ( Byung Suk Lee )

Abstract

The author performed dacryocystorhinostomy on 31 cases which were diagnosed of obstruction of the nasolacrimal duct and the chronic dacryocystitis from February, 1976. to July, 1978. A modified Dupuy-Dutemps method was applied as a surgical technique. To simplify the operation, the bony opening was created by Niedermeier-Weingeist trephine and no suture was used to unite the posterior flaps but instead, gelfoam was left in the newly created nasolacrimal channel. Thus the anterior flap of sac was sutured to the anterior border of the periosteum. Follow up study was done over 6 months after discharge from the hospital. The resu1ts of this observation were as fo1low: 1. The sex distribution showed a preponderance in female, the ratio ma1e to ferna1e being 1:2. 2. The age of the caseg ranged from 4 years of age to 78 years of age. The majority of the cases were from 40 to 5O years old (33.3 %). 3. Postoperative complications were few, but they consisted of mild nasal bleeding (1 case). fistula formation (1 case), abscess of skin incision (1 case), and granu1ation tissue formation (1 case). These complications could be easily treated by usual treatment and reoperation. 4. The success rate by auther's techinque was 93.5 %. The cause of 2 failures were organized granulation tissue and atrophic change of the lacrimal sac, the former failure wag treated by reoperation. In conclusion, this procedure is technically easy and the operating time is short within the range of any ophtha1mic surgeon. I am convinced that dacryocystorhinostomy is the best treatment of tearing and chronic suppuration of the lacrimal sac due to obstruction of the nasolacrimal duct, and is successful in a high percentage.