Endonasal endoscopic dacryocystorhinostomy combined with RS-type lacrimal drainage tube placement and dilatation stent in the treatment of chronic dacryocystitis in patients with small lacrimal sac

Abstract:

AIM: To investigate the efficacy of endonasal endoscopic dacryocystorhinostomy(EES-DCR)combined with RS-type lacrimal drainage tube placement and dilatation stent in the treatment of chronic dacryocystitis in patients with small lacrimal sac.

METHODS: A total of 298 patients(298 eyes)of chronic dacryocystitis with small lacrimal sac admitted to our hospital from December 2018 to December 2023 were retrospectively analyzed. They were divided into two groups according to different treatment modalities, 149 patients(149 eyes)in the control group underwent EES-DCR combined with RS-type lacrimal drainage tube placement, and 149 patients(149 eyes)in the observation group were combined with expansion stents on the basis of the control group. The efficacy of the two groups at 6 mo postoperatively, the changes in ocular indexes \〖Schirmer I test(SⅠt), tear film break-up time(BUT), and degree of tear overflow\〗 at 3 mo postoperatively, the changes in the degree of pain at 3 and 6 mo postoperatively, and the occurrence of complications were compared.

RESULTS: The efficacy of the observation group was better at 6 mo postoperatively(P<0.05). Compared with the preoperative period, the BUT was significantly higher and the degree of SⅠt and tear overflow was significantly lower in the two groups at 3 mo postoperatively, and it was better in the observation group(both P<0.05). There were differences in visual analogue scale(VAS)scores between the two groups at each time point(F_interaction=181.032, P_interaction<0.001; F_time=138.215, P_time<0.001; F_{between groups}=41.343, P_{between groups}<0.001). Compared with the preoperative period, the postoperative VAS scores of patients in both groups were reduced(observation group: t_{3 mo postoperatively}=22.086, t_{6 mo postoperatively}=35.192, both P<0.001; control group: t_{3 mo postoperatively}=19.031, t_{6 mo postoperatively}=36.960, both P<0.001). VAS scores were smaller in the observation group than in the control group at 3 mo postoperatively(t=5.124, P<0.001). Complications were not statistically different between the two groups at 6 mo pastoperatively(P>0.05).

CONCLUSION: EES-DCR combined with RS-type lacrimal drainage tube placement in the treatment of chronic dacryocystitis in patients with small lacrimal sac has a better effect, effectively improves the patient's ocular condition and relieves pain.