[Functional nasolacrimal duct decompression for chronic dacryocystitis].

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Medical Imaging
• Surgical Innovation

Background:

• Chronic dacryocystitis, characterized by nasolacrimal duct obstruction, significantly impacts patients' quality of life.
• Traditional surgical interventions for dacryocystitis carry risks and may not always preserve natural lacrimal passage anatomy.

Purpose of the Study:

• To evaluate the feasibility and efficacy of endoscopic nasolacrimal decompression for treating chronic dacryocystitis.
• To assess the anatomical feasibility of the endoscopic approach using 3D reconstructions and cadaveric studies.

Main Methods:

• Twenty-two patients with chronic dacryocystitis underwent lacrimal sac angiography with 30% iohexol, followed by CT scans.
• 3D reconstructions of the lacrimal passage were created using Sinuses Trachea Isoftware to simulate decompression.
• Cadaveric studies on ten adult frozen heads were performed to simulate endoscopic decompression and membranous nasolacrimal duct dilation.

Main Results:

• Lacrimal duct obstruction was predominantly located in the nasolacrimal duct segment (72.7% of cases).
• Anatomical examination confirmed the bony and membranous structures of the nasolacrimal duct relevant to decompression.
• Cadaveric simulations demonstrated successful decompression of the osseous nasolacrimal duct and dilation of the membranous segment with a balloon catheter.

Conclusions:

• Endoscopic nasolacrimal decompression is a viable surgical option for chronic dacryocystitis.
• The technique effectively preserves the integrity of the lacrimal duct, facilitating drainage.
• This approach prevents post-operative obstruction caused by lacrimal granulation, improving outcomes.