ÖZET
Amaç: Eksternal dakriyosistorinostomi ameliyatinda bikanaliküler slikon tüp entübasyonu endikasyonlarini arastirmak ve basari oranlarimizi belirlemek.
Gereç ve Yöntem: Nisan 2000-Temmuz 2003 tarihleri arasinda Haseki Egitim ve Arastirma Hastanesi Göz Klinigi'nde Dupuy-Dutemps-Bourget teknigi ile eksternal dakriyosistorinostomi ve bikanaliküler silikon tüp entübasyonu yapilan 48 hastanin 50 gözü çalisma kapsamina alindi. Hastalarin 40'i kadin, 8'i erkek olup yas ortalamalari 45 (15-80 yas) idi. Silikon tüp entübasyonu 19 hastada küçük ve fibrotik kese, 9 hastada daha önce geçirilmis basarisiz lakrimal cerrahi, 9 hastada ortak kanalikül medial uç darligi veya tikanikligi, 7 hastada dakriyosistorinostomi ameliyati sirasinda gelisen teknik sorunlar, 3 hastada mukosel ve 3 hastada ortak kanalikül lateral uç tikanikligi nedeniyle yapildi. Hastalar ortalama 18 ay (4-37 ay) takip edildiler ve tüpler ortalama 4 ay (1-9 ay) sonra alindi.
Bulgular: Ilk ameliyatlar sonunda 50 gözün 42'sinde (%84) basari elde edildi ve epifora sikayetleri giderildi. Basarisiz kalan 8 olgunun 2'si ikinci operasyonu kabul etti ve yapilan ikinci ameliyatlarla iki olguda da basarili sonuç alindi. Sonuç olarak 50 gözün 44'ünde (%88) basari elde edildi. Iki olguda konjonktiva irritasyonu, 3 olguda tüp prolapsusu, 1 olguda ise kanaliküler kesilme gibi tüpe bagli komplikasyonlar izlendi.
Sonuç: Silikon tüp entübasyonu dogru endikasyon ve uygun cerrahi teknikle birlestirildiginde lakrimal drenaj sistem cerrahisinde basarinin artacagi kuskusuzdur. Silikon tüpe bagli komplikasyonlar akilda tutularak, olgular uygun araliklarla takip edilmeli ve tüp yeterli süre bekletildikten sonra alinmalidir.
Anahtar Kelimeler: Kronik dakriyosistit, Dakriyosistorinostomi, Silikon tüp entübasyonu
Indications of Silicon Tube Intubation in External Dacryocystorhinostomy
SUMMARY
Purpose: To investigate the indications of bicanalicular silicon tube intubations in external dacryocystorhinostomy (DCR) operation and to determine our success ratio.
Material and Methods: External DCR by Dupuy-Dutemps-Bourget technique and bicanalicular silicon tube intubation were performed in 50 eyes of 48 patients (40 female, 8 male) in Haseki Education and Research Hospital between April 2000-July 2003. The mean age of 48 patients were 45 (15-80 ) years. Silicon tube was implanted for small fibrotic sac in 19 cases, for failed previous lacrimal surgery in 9 cases, for stenosis and obstruction of canalicular medial end in 9 cases, for technical problems during operation in 7 cases, for mucosele in 3 cases and for obstruction of canalicular lateral end in 3 cases. The mean follow up was 18 (4-37) months and tubes were removed approximately 4 (1-9) months after operation.
Results: The success rate was %84 in 42 of 50 eyes after primary operations. From the remaining 8 patients, 2 cases accepted reoperation and successful results were acquired from these two patients. As a conclusion 44 of 50 eyes (%88) were treated successfully. Two cases had conjunctival irritation, 3 cases had prolapsus of tube, 1 case had canalicular laseration as complications due to silicon tube.
Conclusion: The success rate of lacrimal drainage surgery will increase when silicone tube intubation is performed with correct indications and surgical techniques. As complications due to silicon tube must be kept in mimd, cases should be followed up with certain intervals and silicon tube should be removed on time.
Key Words: Chronic dacriocystitis, Dacryocystorhinostomy, Silicon tube intubation
