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P.-J. Bertaux, J.-M. Perone, B. Batta, J. Conart, A. Robin, I. Allal, H. Mnasri, M. Al Saoub; Endonasal Dacryocystrhinostomy Evolution of the Stomies Size. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4145.
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Endonasal dacryocystorhinostomy proved its efficiency in post-canalicular lacrymo-nasal duct obstructions or dacryocytitis treatment. Failure of such a surgery may be the consequence of a progressive stenosis of the nasal ostium. The purpose of this study is to show the evolution of the nasal ostium’s size by direct measure. It has never been shown before.
Prospective, not randomized study, concerning 18 consecutive patients (26 DCR) all operated on between 22/01/2008 and 01/04/2009, for naso-lacrymal duct obstruction or chronic dacryocystitis. A fibroscopic control is made every 2 months, and the stomies size is measured on a picture after positioning near openings a 2mm calibrated otologic hook. (every stomy is compared to an ellipse with a small and a big diameter). A statistical analysis of the measurement system is made to ensure data’s validity (Repeatability and Reproductibility). Then we use an ANOVA to evaluate the stomies size evolution.
The measurement system is correct for the evaluation of the big diameter. 19 stomies (73,1 %) are measurable and functional to M2. The average size of the big diameter is 1,44 +/-0,61mm, of the small diameter is 0,86 +/-0,37mm, and the average area is 1,10 +/-0,84mm2. We regret 3 failures on 26 DCR (the success rate at M2 : 88,5 %). The evolution is marked by a statistically significant decrease of the stomies size between M2 and M4. Followed by a stabilization with a 9 months mean follow-up.
In our study we showed, with a repeatable and reproductible measure system, a spontaneous fast shrinkage of the stomy’s size in the 2 months following the ablation of the IBCN probe at M2. Then a stabilization, without preoperative predictive factor. We do not find direct correlation between the shrinkage and the functional failure.
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