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Erkennung und Vermeidung von Schwierigkeiten bei der Tränenwegschirurgie

Recognition and prevention of problems in lacrimal duct surgery

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Zusammenfassung

Die operative Versorgung der intra- und postsakkalen Tränenwegstenose gehört zu den besonders erfolgversprechenden Eingriffen des Fachgebiets. Um das Potenzial der endonasalen Dakryozystorhinostomie ganz auszuschöpfen, um Fehler in der Auswahl der Patienten, in der technischen Durchführung, aber auch in der Kommunikation mit den Kollegen der Ophthalmologie zu vermeiden, müssen einige diagnostische und differenzialindikatorische Aspekte berücksichtigt werden. Geordnet nach dem klinischen Ablauf der Patientenversorgung werden diese hier vor dem Hintergrund der aktuellen Literatur dargestellt.

Abstract

Surgical management of lacrimal duct obstruction beyond the canaliculi proves to be a promising endeavor in most cases. To realize the full potential of endonasal dacryocystorhinostomy, some aspects of diagnosis and differential indication setting should be considered in order to avoid errors and problems during patient selection, execution of the technical procedure, and communication with ophthalmologists. These issues are described according to the clinical management of patients; current literature is cited.

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Literatur

  1. Ali MJ, Psaltis AJ, Murphy J et al (2015) Endoscopic dacryocystorhinostomy and obstructive sleep apnoea: the effects and outcomes of continuous positive airway pressure therapy. Clin Exp Ophthalmol 43:405–408

    Article  PubMed  Google Scholar 

  2. Amin S, Emmerich KH, Meyer-Rusenberg HW (2013) Modern, minimally invasive surgery of the lacrimal duct system. HNO 61:1053–1059 (quiz 1060)

    Article  PubMed  CAS  Google Scholar 

  3. Anastas CN, Potts MJ, Raiter J (2001) Mini Monoka silicone monocanalicular lacrimal stents: subjective and objective outcomes. Orbit 20:189–200

    Article  PubMed  Google Scholar 

  4. Biro N, Murchison AP, Pribitkin EA et al (2013) Air reflux and other sequelae following endoscopic dacryocystorhinostomy. Ophthal Plast Reconstr Surg 29:386–388

    Article  PubMed  Google Scholar 

  5. Cheng SM, Feng YF, Xu L et al (2013) Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis. PLoS ONE 8:e62737

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. El-Sawy T, Frank SJ, Hanna E et al (2013) Multidisciplinary management of lacrimal sac/nasolacrimal duct carcinomas. Ophthal Plast Reconstr Surg 29:454–457

    Article  PubMed  Google Scholar 

  7. Fay A, Dolman PJ (2017) Diseases and disorders of the orbit and ocular adnexa. Elsevier, Edinburgh, S 557–577

    Google Scholar 

  8. Ginzkey C, Mlynski R (2016) Treatment of nasolacrimal duct obstruction from the otorhinolaryngologist’s perspective. HNO 64:394–402

    Article  PubMed  CAS  Google Scholar 

  9. Von Goscinski C, Koch KR, Cursiefen C et al (2016) Tumors of the lacrimal drainage system. HNO 64:386–393

    Article  Google Scholar 

  10. Harish V, Benger RS (2014) Origins of lacrimal surgery, and evolution of dacryocystorhinostomy to the present. Clin Exp Ophthalmol 42(3):284–287. https://doi.org/10.1111/ceo.12161

    Article  PubMed  Google Scholar 

  11. Heichel J, Bredehorn-Mayr T, Bohm K et al (2016) Bony lacrimal duct stenosis and hand abnormalities as signs of systemic disease. HNO 64:424–428

    Article  PubMed  CAS  Google Scholar 

  12. Heichel J, Bredehorn-Mayr T, Struck HG (2016) Congenital nasolacrimal duct obstruction from an ophthalmologist’s point of view : causes, diagnosis and staged therapeutic concept. HNO 64:367–375

    Article  PubMed  CAS  Google Scholar 

  13. Heichel J, Sandner A, Siebolts U et al (2016) Concretions and iatrogenic foreign bodies in the lacrimal system: treatment recommendations. HNO 64:403–416

    Article  PubMed  CAS  Google Scholar 

  14. Herberhold S, Lindner R, Wilhelm K et al (2013) Dacryocystorhinostomy as part of the interdisciplinary treatment of lacrimal duct. HNO 61:851–858

    Article  PubMed  CAS  Google Scholar 

  15. Hodgson N, Bratton E, Whipple K et al (2014) Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation. Ophthal Plast Reconstr Surg 30:24–27

    Article  PubMed  Google Scholar 

  16. Horn IS, Tittmann M, Fischer M et al (2013) Endonasal nasolacrimal duct surgery: a comparative study of two techniques. Eur Arch Otorhinolaryngol 271(7):1923–1931. https://doi.org/10.1007/s00405-013-2774-8

    Article  PubMed  Google Scholar 

  17. Jones LT (1977) Lacrimal fluorescein test. Am J Ophthalmol 83:762

    Article  PubMed  CAS  Google Scholar 

  18. Kaynak P, Ozturker C, Yazgan S et al (2014) Transcanalicular diode laser assisted dacryocystorhinostomy in primary acquired nasolacrimal duct obstruction: 2‑year follow up. Ophthal Plast Reconstr Surg 30:28–33

    Article  PubMed  Google Scholar 

  19. Kominek P, Cervenka S, Zelenik K et al (2013) Lacrimal sac dacryolith (76 cases): a predictive factor for successful endonasal dacryocystorhinostomy? Eur Arch Otorhinolaryngol. https://doi.org/10.1007/s00405-013-2787-3

    Article  PubMed  Google Scholar 

  20. Kuhnel TS, Reichert TE (2015) Trauma of the midface. GMS current topics in otorhinolaryngology. Head Neck Surg 14:Doc6

    Google Scholar 

  21. Kühnel T, Hosemann W, Wagner W et al (1996) Does mechanical local aftercare following sinus surgery traumatize regenerating mucosa? A histological and immunohistochemical investigation. Laryngorhinootologie 75:575–579

    Article  PubMed  Google Scholar 

  22. Kühnel T, Hosemann W, Weber R et al (2014) Tränenwegschirurgie. Die wichtigsten Kriterien für dauerhaften Erfolg. HNO Nachr 44:28–31

    Article  Google Scholar 

  23. Lee DW, Chai CH, Loon SC (2010) Primary external dacryocystorhinostomy versus primary endonasal dacryocystorhinostomy: a review. Clin Exp Ophthalmol 38:418–426

    Article  PubMed  Google Scholar 

  24. Mohamad SH, Khan I, Shakeel M et al (2013) Long-term results of endonasal dacryocystorhinostomy with and without stenting. Ann R Coll Surg Engl 95:196–199

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  25. Naraghi M, Tabatabaii Mohammadi SZ, Sontou AF et al (2012) Endonasal endoscopic dacryocystorhinostomy: how to achieve optimal results with simple punch technique. Eur Arch Otorhinolaryngol 269:1445–1449

    Article  PubMed  Google Scholar 

  26. Nash M, Skippen B, Gal A et al (2015) The role of routine biopsy of the lacrimal sac during dacryocystorhinostomy surgery. Orbit 34:320–323

    Article  PubMed  Google Scholar 

  27. Nussbaumer M, Schreiber S, Yung MW (2004) Concomitant nasal procedures in endoscopic dacryocystorhinostomy. J Laryngol Otol 118:267–269

    Article  PubMed  Google Scholar 

  28. Osguthorpe JD, Hoang G (1991) Nasolacrimal injuries. Evaluation and management. Otolaryngol Clin North Am 24:59–78

    PubMed  CAS  Google Scholar 

  29. Qian Z, Tu Y, Xiao T et al (2015) A lacrimal sump syndrome with a large intranasal ostium. J Craniofac Surg 26:e386–e388

    Article  PubMed  Google Scholar 

  30. Repp DJ, Burkat CN, Lucarelli MJ (2009) Lacrimal excretory system concretions: canalicular and lacrimal sac. Ophthalmology 116:2230–2235

    Article  PubMed  Google Scholar 

  31. Shams PN, Chen PG, Wormald PJ et al (2014) Management of functional epiphora in patients with an anatomically patent dacryocystorhinostomy. JAMA Ophthalmol 132:1127–1132

    Article  PubMed  Google Scholar 

  32. Silbert DI, Matta NS (2010) Outcomes of 9 mm balloon-assisted endoscopic dacryocystorhinostomy: retrospective review of 97 cases. Orbit 29:131–134

    Article  PubMed  Google Scholar 

  33. Struck HG, Glien A, Herzog M et al (2016) The Interdisciplinary Conference on Lacrimal System Disorders of ophthalmic and ENT surgeons at the University Hospital Halle : An analysis of present patient material. HNO 64:417–423

    Article  PubMed  Google Scholar 

  34. Tao H, Ma ZZ, Wu HY et al (2013) Anatomic study of the lacrimal fossa and lacrimal pathway for bypass surgery with autogenous tissue grafting. Indian J Ophthalmol 62(4):419–423. https://doi.org/10.4103/0301-4738.121137

    Article  Google Scholar 

  35. Varde M, Wiechens B (2016) Tränenwegchirurgie. In: Welkoborsky HJ, Wiechens B, Hinni M (Hrsg) Orbita: Interdisziplinäres Management der Orbitaerkrankungen. Thieme, Stuttgart, S 288–306

    Google Scholar 

  36. Whitnall SE (1913) The relations of the lacrimal fossa to the ethmoidal cells. Ophthal Rev 32:321–325

    Google Scholar 

  37. Wormald PJ (2013) Endoscopic sinus surgery. Anatomy, three-dimensional reconstruction, and surgical technique. Thieme, New York, Stuttgart

    Google Scholar 

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Authors and Affiliations

  1. Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    T. Kühnel

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Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Kühnel, T. Erkennung und Vermeidung von Schwierigkeiten bei der Tränenwegschirurgie . HNO 66, 432–437 (2018). https://doi.org/10.1007/s00106-018-0507-4

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