Gian Marco Pace, Francesco Giombi, Francesca Pirola, Elena Russo, Michele Cerasuolo, Jessica Zuppardo, Giovanna Muci, Gianmarco Giunta, Alessandra Di Maria, Mario R. Romano, Giuseppe Mercante, Giuseppe Spriano, Luca Malvezzi
{"title":"内窥镜鼻腔内泪囊鼻腔造口术:久治不愈的疾病对手术效果的影响","authors":"Gian Marco Pace, Francesco Giombi, Francesca Pirola, Elena Russo, Michele Cerasuolo, Jessica Zuppardo, Giovanna Muci, Gianmarco Giunta, Alessandra Di Maria, Mario R. Romano, Giuseppe Mercante, Giuseppe Spriano, Luca Malvezzi","doi":"10.1007/s00405-024-08956-8","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To assess whether the duration of disease may influence the surgical success of Endonasal Endoscopic DCR (EE-DCR) in patients affected by nasolacrimal duct obstruction (NLDO).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Single-center observational retrospective analysis on EE-DCR via posterior trans-ethmoidal approach. Consecutive patients were enrolled in 2021–2024 and evaluated with proper questionnaires; resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Also, patients were asked to complete the Hospital Anxiety and Depression Scale (HADS) at each timepoint. The sample was divided based on the duration of disease (group A: ≤ 24 months, group B: > 24 months).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Ninety-one patients were included. At baseline no differences were observed between the two groups. At both timepoints, Munk score was significantly lower in Group A compared to Group B, while a difference in dacryocystitis rate was observed only at T2. Anxiety scores differed significantly at T2, although no differences were observed for depression. At paired analysis, all groups improved significantly at T1 compared to baseline, whereas no further improvement was observed between T2 and T1. A significantly higher improvement was observed in group A for the Munk and HADS-A scores over timepoints, whereas there was no significance for dacryocystitis rate and HADS-D. Also, group A showed a higher complete success rate compared to group B (<i>p</i> = 0.041). Finally, linear regression confirmed a positive relationship between Munk and anxiety scores and the duration of disease at T2.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Our findings showed that long-lasting NLDO symptoms may be associated with worse EE-DCR surgical outcomes.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":"89 1","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endoscopic endonasal dacryocystorhinostomy: impact of long-standing disease on surgical outcomes\",\"authors\":\"Gian Marco Pace, Francesco Giombi, Francesca Pirola, Elena Russo, Michele Cerasuolo, Jessica Zuppardo, Giovanna Muci, Gianmarco Giunta, Alessandra Di Maria, Mario R. 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The sample was divided based on the duration of disease (group A: ≤ 24 months, group B: > 24 months).</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Ninety-one patients were included. At baseline no differences were observed between the two groups. At both timepoints, Munk score was significantly lower in Group A compared to Group B, while a difference in dacryocystitis rate was observed only at T2. Anxiety scores differed significantly at T2, although no differences were observed for depression. At paired analysis, all groups improved significantly at T1 compared to baseline, whereas no further improvement was observed between T2 and T1. A significantly higher improvement was observed in group A for the Munk and HADS-A scores over timepoints, whereas there was no significance for dacryocystitis rate and HADS-D. Also, group A showed a higher complete success rate compared to group B (<i>p</i> = 0.041). 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Endoscopic endonasal dacryocystorhinostomy: impact of long-standing disease on surgical outcomes
Purpose
To assess whether the duration of disease may influence the surgical success of Endonasal Endoscopic DCR (EE-DCR) in patients affected by nasolacrimal duct obstruction (NLDO).
Methods
Single-center observational retrospective analysis on EE-DCR via posterior trans-ethmoidal approach. Consecutive patients were enrolled in 2021–2024 and evaluated with proper questionnaires; resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Also, patients were asked to complete the Hospital Anxiety and Depression Scale (HADS) at each timepoint. The sample was divided based on the duration of disease (group A: ≤ 24 months, group B: > 24 months).
Results
Ninety-one patients were included. At baseline no differences were observed between the two groups. At both timepoints, Munk score was significantly lower in Group A compared to Group B, while a difference in dacryocystitis rate was observed only at T2. Anxiety scores differed significantly at T2, although no differences were observed for depression. At paired analysis, all groups improved significantly at T1 compared to baseline, whereas no further improvement was observed between T2 and T1. A significantly higher improvement was observed in group A for the Munk and HADS-A scores over timepoints, whereas there was no significance for dacryocystitis rate and HADS-D. Also, group A showed a higher complete success rate compared to group B (p = 0.041). Finally, linear regression confirmed a positive relationship between Munk and anxiety scores and the duration of disease at T2.
Conclusions
Our findings showed that long-lasting NLDO symptoms may be associated with worse EE-DCR surgical outcomes.
期刊介绍:
Official Journal of
European Union of Medical Specialists – ORL Section and Board
Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery
"European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level.
European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.