Endoscopic T-tube application in inferior dacryocystorhinostomy

Abstract EN

To assess the efficacy of T-tube application .which is used in management of middle ear effusion, in endoscopic laser assisted DCR via a surgical window in the area of ultra thin lacrimal bone in relieving post-saccal obstruction of the naso-lacrimal ducts.

Nineteen Patients diagnosed, as having nasolacrimal duct obstruction were included in this study.

Endoscopic diode laser assisted DCR with minimal bone work was done for all cases, then T-tube was applied to maintain the patency of the ostium instead of the silicone intubation At the end of six months 15 out of 19 patients (78.9%) were relieved of their symptoms completely, wtiile 4 patients (21.1%) continued to have persistent epiphora.

The success rate was about 79%.

Endoscopic diode laser assisted DCR with otologic T- tube application compares favorably with silicone stenting described in the literatures.

This technique has the following advantages : Easy, T-tube is a cheap, self-retaining stent, less granulomatous reaction ,can be done under local anesthesia, less operative time Jess intraoperative bleeding Jess postoperative morbidity Jaster patient recovery, the procedure can be repeated, and bilateral cases can be performed in the same setting.

We think that: a T tube with a wider caliber and of a suitable length is needed, the material of the tube must be harder, and an applicator is needed to facilitate the insertion of the tube inside the sac.

Long term follow up is essential.