歯学ジャーナル
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概要

Evaluation of the Cosmetic and Functional Outcomes of the Subciliary Incision for External Dacryocystorhinostomy

Hossameldeen Elsayed Elbarbary

This study was a prospective interventional case series evaluating the subciliary incision for external dacryocystorhinostomy. It has a high functional success outcome and an excellent satisfying scar outcome to the surgeon and the patient.
Purpose: To evaluate the cosmetic and functional outcomes of subciliary incision for external dacryocystorhinostomy (DCR).
Methods: This study was a prospective interventional case series. Forty eyes of external DCR for primary acquired nasolacrimal duct obstruction were done through the subciliary skin approach. Successful functional outcome was defined as relief from epiphora, and normal Fluorescein Disappearance Test (FDT). The cosmetic outcome of the scar was evaluated objectively by the surgeon and subjectively by the patients using the scar grading scale of the postoperative photographs: 0: invisible incision;1: minimally visible incision; 2: moderately visible incision; and 3: very visible incision. The follow up visits were done over a period of 6 months after surgery.
Results: The study included Forty eyes of 36 patients. Primary external DCR through subciliary approach was done for all cases over a period of 42 months starting from July 2013 to December 2016. The functional success was 95% as epiphora was resolved in 38 out of 40 eyes with normal Fluorescein Disappearance Test at 3 months after surgery. Objective grading of the scars was 100% invisible (grade 0) and Subjective scar grading by the patients was 100% invisible (grade 0) at the end of the postoperative follow up visits.
Conclusions: The subciliary incision for external DCR has a high functional success outcome and an excellent satisfying scar outcome to the surgeon and the patient The subciliary approach was simply an attempt to combine the best of 2 worlds, namely subciliary incision and external DCR.