By Livio Presutti, Francesco Mattioli
This handbook covers all features of endoscopic surgical procedure of the lacrimal drainage method. step by step descriptions are supplied of endoscopic dacryocystorhinostomy (DCR) and its use in revision surgical procedure, observed through various useful pictures and anatomical drawings. furthermore, transparent stream charts are integrated to help in diagnostic and surgical choice making and establish surgical symptoms. crucial info is supplied on anatomy, body structure and pathology and a person bankruptcy is dedicated to imaging of the lacrimal drainage method. extra themes contain lacrimal probes and stents, strength problems of surgical procedure, and endoscopic DCR within the pediatric age team. This ebook will help the practitioner in negotiating the steep studying curve occupied with gaining the talents had to practice endoscopic surgical procedure of the lacrimal drainage approach, which bargains major benefits by way of avoidance of exterior incisions and upkeep of the lacrimal pump.
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Sample text
Age, bilaterality, failed previous probing, failed conservative treatment, dilated sac, and non-membranous CNLDO have a significant negative impact on the success of probing [12]. Failure rates increase in case of dacryocystitis, dacryocele, and concomitant canalicular stenosis. In case of failure, probing could be repeated, with balloon dilation and/or with bicanalicular and monocanalicular intubation [9,13] with placement of a silicon tube that will be removed after 2–6 months. Corneal or conjunctival abrasion from the tube, granuloma formation, and canalicular slitting may necessitate early tube removal.
8). Conversely, iso- to hyperintense T2 signal is more indicative of a benign lesion with less cellular density, such a mixed tumors. Unfortunately, none of the abovementioned criteria provides clear-cut differential diagnosis. The application of diffusion-weighted (DWI) MRI sequences might potentially increase the accuracy, at least in the discrimination between benign and malignant. Such technique measures the motion (referred to as diffusion) of water molecules in tissues. When applied to head and neck malignant tumors in various sites, DWI showed differences in water diffusion (apparent diffusion coefficient, ADC) between lymphomas (very low ADC), malignant tumors (low ADC), and benign tumors (high ADC) [23, 24].
Eur J Radiol 55:331–339 Berkefeld J, Kirchner J, Muller HM, Fries U, Kollath J (1997) Balloon dacryocystoplasty: indications and contraindications. Radiology 205:785–790 Lee JS, Jung G, Oum BS, Lee SH, Roh HJ (2000) Clinical efficacy of the polyurethane stent without fluoroscopic guidance in the treatment of nasolacrimal duct obstruction. Ophthalmology 107:1666–1670 Kang SG, Song HY, Lee DH, Choi JY, Ahn HS (2002) Nonsurgically placed nasolacrimal stents for epiphora: long-term results and factors favoring stent patency.