Related Experiment Video
Updated: Sep 4, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Endoscopic and radiological evidence refuting intra-abscess septae
Nandini Bothra1, Pragya Saini1, Mohammad Javed Ali1
1Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India.
Purpose:
To investigate the presence of septae within the lacrimal abscess and to explore simple aspiration as an alternative to the traditional management by incision and drainage.
Methods:
Prospective, interventional pilot study involved eight lacrimal sac abscesses of eight patients over a period of three months. All patients underwent a pre-operative MRI with surface coils followed by aspiration of the abscess (n = 4) or incision and drainage of the abscess (n = 4). An intra-sac endoscopic evaluation was performed during the abscess drainage. Primary outcome measures - presence or absence of septae on MRI scan images and endoscopic evaluation of the abscess cavity. Secondary outcome measures - relief from pain and symptoms following aspiration and anatomical patency following definitive management.
Results:
Eight patients underwent either aspiration (n = 4) or incision and drainage of the abscess (n = 4). Mean age of the patients 43.3 years and male to female ratio was 1:1. Left eye involvement was more common (Right: left = 1:3). Average duration of acute symptoms - 3.75 days. High resolution MRI showed a well- defined abscess cavity with few undulations which on endoscopic evaluation correlated with oedematous mucosal folds. There was absence of a loculi or septae within the abscess cavity. Definitive surgery in the form of endoscopic DCR was performed for all the patients with post-operative FICI grading was +5.
Conclusion:
The present study refutes the presence of septae within the abscess cavity and proposes aspiration of the lacrimal sac abscess as a minimally invasive procedure with minimal logistics and a shallow learning curve.
Insights
This study found no septae in lacrimal sac abscesses, suggesting simple aspiration is a viable, minimally invasive alternative to traditional incision and drainage for managing these conditions.
Area of Science:
- Ophthalmology
- Oculoplastics
- Medical Imaging
Background:
- Lacrimal sac abscesses are typically managed with incision and drainage.
- The presence of internal septations can complicate management.
- Magnetic Resonance Imaging (MRI) and endoscopic evaluation can assess abscess characteristics.
Purpose of the Study:
- To investigate the presence of septae within lacrimal sac abscesses.
- To evaluate simple aspiration as a minimally invasive alternative to incision and drainage.
Main Methods:
- A prospective pilot study of eight patients with lacrimal sac abscesses.
- Pre-operative MRI and intra-sac endoscopic evaluation were performed.
- Patients were randomized to aspiration (n=4) or incision and drainage (n=4).
Main Results:
- High-resolution MRI revealed well-defined abscess cavities without septae or loculi.
- Endoscopic evaluation correlated MRI findings with edematous mucosal folds.
- All patients achieved symptom relief and anatomical patency post-treatment.
Conclusions:
- The study refutes the presence of septae within lacrimal sac abscesses.
- Simple aspiration is proposed as a safe, minimally invasive, and effective treatment.
- Aspiration offers advantages in terms of logistics and learning curve compared to traditional methods.
More Related Videos
07:41Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
08:00Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
Published on: June 15, 2015