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Sums of Power01:22

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In definite integration, Riemann sums approximate the area under a curve by dividing it into subintervals and summing the areas of rectangles. When these approximations follow predictable numerical patterns, such as arithmetic or polynomial sequences, sum formulas offer a more efficient and accurate way to compute the result. In particular, the sum of consecutive integers, squares, and cubes plays an essential role in simplifying these calculations, especially when dealing with uniform...
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Powered endoscopic dacryocystorhinostomy with selective stenting.

Claudio A Callejas1, Marc A Tewfik, Peter-John Wormald

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Selective silicone stenting shows no significant difference in surgical outcomes for primary powered endoscopic dacryocystorhinostomy (DCR) compared to routine stenting for nasolacrimal duct obstruction (NLDO). A selective approach is advocated when a tight opening is identified during surgery.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Oculoplastics

Background:

  • Nasolacrimal duct obstruction (NLDO) affects tear drainage, necessitating surgical intervention.
  • Endoscopic dacryocystorhinostomy (DCR) is a common surgical approach for NLDO.
  • The role of silicone stenting in primary endoscopic DCR outcomes remains a subject of investigation.

Purpose of the Study:

  • To compare the surgical outcomes of primary powered endoscopic DCR with selective versus routine silicone stenting.
  • To evaluate the efficacy of selective stenting in cases of anatomic and functional NLDO.

Main Methods:

  • Prospective nonrandomized cohort study with a historical control group.
  • Thirty-one primary powered endoscopic DCR procedures with selective stenting were compared to 31 historical controls with routine stenting.
  • Preoperative assessment included irrigation, dacryocystography, and lacrimal scintigraphy; success was defined by symptom absence and a patent nasolacrimal system.

Main Results:

  • Overall success rate was 79%.
  • Success rates for anatomic NLDO were 100% (selective) and 94.7% (routine); for functional NLDO, 60.9% (selective) and 75% (routine).
  • No statistically significant difference in success rates was observed between selective and routine stenting for either NLDO type (P > .05).

Conclusions:

  • Primary powered endoscopic DCR demonstrates comparable surgical outcomes regardless of selective or routine silicone stenting.
  • A selective stenting approach is recommended, with stent insertion only when a tight common canaliculus opening is encountered during surgery.
  • This approach may optimize resource utilization and patient management in endoscopic DCR procedures.