Features of surgical treatment of nasolacrimal duct stenoses in children

2014 ◽  
Vol 5 (2) ◽  
pp. 30-34
Author(s):  
Vladimir Vsevolodovich Brzheskiy ◽  
Margarita Nikolayevna Chistyakova ◽  
Irina Vyacheslavovna Kalinina
Keyword(s):  
Surgical Treatment ◽  
Inflammatory Response ◽  
Nasolacrimal Duct ◽  
Control Group ◽  
Functional Effect ◽  
Lacrimal System ◽  
Group A ◽  
Silicone Intubation ◽  
Canalicular Stenosis ◽  
Lacrimal Drainage

42 children at age from 1 to 15 years (36 - with relapse of congenital nasolacrimal duct (NLD ) stenosis and 6 - with canalicular stenosis) bougienage NLD was done with Ritleng stent intubation. The control group included 25 children 1-5 years old with relapsed congenital stenosis of the NLD, the treatment of which was limited to probing the NLD. In the first group full functional effect was observed in 21 children (58.3 %), in 9 (25.0 %) - was light epiphoria, in 1 (2.8 %) - moderate, and in 5 (13.9 % ) treatment was not effective. In the second group a full functional effect was obtained for each child. In the control group lacrimal drainage was restored fully in 16 (64.0 %) children, in 2 (8.0 %) - moderate and in 7 (28.0 %) - severe epiphora was remained. Using of silicone intubation with the Ritleng lacrimal system allows to continuously retain their foramen in stenotic site without causing an inflammatory response and bedsores lacrimal punctum and canaliculus.

scholarly journals Pulled versus Pushed Monocanalicular Silicone Intubation in Adults with Lacrimal Drainage System Stenosis: A Comparative Case Series

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Abolfazl Kasaee ◽  
Bahram Eshraghi ◽  
Kambiz Ameli ◽  
Hossein Ghahvehchian ◽  
Mansooreh Jamshidian-Tehrani ◽  
...  
Keyword(s):  
Success Rate ◽  
Drainage System ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Lacrimal Drainage System ◽  
Tube Removal ◽  
Silicone Intubation ◽  
Canalicular Stenosis ◽  
Grade 3 ◽  
Lacrimal Drainage

Purpose. To compare the success rate and complications of pulled versus pushed monocanalicular intubation in adults with incomplete lacrimal drainage system obstruction (lacrimal drainage system stenosis). Methods. Patients with lacrimal drainage system stenosis (Munk grade ≥3), including both nasolacrimal duct (NLD) stenosis and common canalicular stenosis, were recruited in this prospective comparative case series. Patients underwent probing and either Monoka (51 eyes) or Masterka (48 eyes) intubation under general or local anesthesia. Tubes were removed 4–14 weeks after the procedure. Six months after tube removal, Munk grades 0 and 1 were defined as a complete success, Munk grade 2 was defined as a partial success, and Munk grade ≥3 was defined as failure. All complications were recorded. Results. Ninety-nine eyes from 89 patients with lacrimal drainage system stenosis who underwent either Monoka (51 eyes) or Masterka (48 eyes) intubation were included. The mean (SD) age of the patients was 55.4 (12) years in the Monoka group and 53.5 (12.9) in the Masterka group. Groups were matched on demographics. Masterka intubation could not be performed in one eye. Complete and partial successes were observed in 52.9% (27/51) and 17.6% (9/51) of eyes in the Monoka group and 42.6% (20/47) and 12.8% (6/47) of eyes in the Masterka group, respectively ( p = 0.29 ). There was a trend toward a higher total success rate in patients with NLD stenosis treated with Monoka 66.7% (26/39) than Masterka 45.5% (15/33) intubation ( p = 0.07 ). This trend also existed in patients with common canalicular stenosis (83.3% (10/12) vs. 76.6% (11/14), p = 0.75 ). Age, sex, bilateral involvement, and duration of intubation did not have a significant impact on the success rate. Early tube loss, slit puncta, and temporary superficial punctate keratopathy were observed complications. Conclusion. Intubation with the pulled monocanalicular silicone tube was associated with a slightly but not significantly higher success rate in adults with lacrimal drainage system stenosis. Patients with NLD stenosis may achieve better results with pulled silicone tubes.

Prospective study of incidence and severity of epiphora and canalicular stenosis in patients with metastatic breast cancer receiving docetaxel

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 659-659
Author(s):  
S. R. Amin ◽  
V. Valero ◽  
E. Rivera ◽  
R. Adinin ◽  
R. Banay ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Prospective Trial ◽  
Metastatic Breast ◽  
Weekly Docetaxel ◽  
Ophthalmologic Examination ◽  
Silicone Intubation ◽  
Canalicular Stenosis ◽  
Weekly Group ◽  
Lacrimal Drainage

659 Background: To determine the incidence and severity of epiphora and canalicular stenosis in patients receiving weekly or every-3-weekly docetaxel. Methods: In this prospective trial, each patient underwent an ophthalmologic examination and probing and irrigation of the lacrimal drainage apparatus at baseline and at every 4–6 weeks after initiation of docetaxel. During each visit, epiphora and canalicular stenosis were graded. Patients with epiphora were treated with Tobradex drops. If epiphora worsened or findings on probing and irrigation suggested further canalicular narrowing, silicone intubation was offered. Results: 28 patients received weekly and 28 patients received every-3-weeks docetaxel. 18(64%) patients who received weekly docetaxel developed epiphora. Epiphora was mild in 7 patients, moderate in 5, and severe in 6. Nine patients had resolution of epiphora with Tobradex. Nine patients had worsened canalicular stenosis; 6 underwent surgery. The median cumulative docetaxel dose was 496.5 mg at onset of epiphora and 889.5 mg at surgery. 11 (39%) patients who received every-3-weeks docetaxel developed epiphora. The median cumulative docetaxel dose at the time of onset of epiphora in this group was 420 mg. Epiphora was mild in 9 patients, moderate in 1, and severe in 1. Nine patients had resolution of epiphora in response to Tobradex. Two patients underwent surgery. Conclusions: Epiphora occurred in 64% of patients in the weekly group and 39% of patients in the every-three-weeks group. Moderate or severe canalicular stenosis was seen in about one-third of patients in the weekly group and none of the patients in the every-3-weeks group. [Table: see text]

New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jose Rojas-Suarez ◽  
Angel Paternina-Caicedo ◽  
Jezid Miranda ◽  
María Cuello ◽  
María Piñerez ◽  
...  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Reference Group ◽  
Systemic Inflammatory Response ◽  
Control Group ◽  
Maternal Outcomes ◽  
Operating Characteristics ◽  
Group A ◽  
Group B ◽  
Obstetric Population

Abstract Objectives We aimed to establish new cut-off values for SIRS (Systemic Inflammatory Response Syndrome) variables in the obstetric population. Methods A prospective cohort study in pregnant and postpartum women admitted with systemic infections between December 2017 and January 2019. Patients were divided into three cohorts: Group A, patients with infection but without severe maternal outcomes (SMO); Group B, patients with infection and SMO or admission to the intensive care unit (ICU); and Group C, a control group. Outcome measures were ICU admission and SMO. The relationship between SIRS criteria and SMO was expressed as the area under the receiver operating characteristics curve (AUROC), selecting the best cut-off for each SIRS criterion. Results A total of 541 obstetric patients were enrolled, including 341 with infections and 200 enrolled as the reference group (Group C). The patients with infections included 313 (91.7%) in Group A and 28 (8.2%) in Group B. There were significant differences for all SIRS variables in Group B, compared with Groups A and C, but there were no significant differences between Groups A and C. The best cut-off values were the following: temperature 38.2 °C, OR 4.1 (1.8–9.0); heart rate 120 bpm, OR 2.9 (1.2–7.4); respiratory rate 22 bpm, OR 4.1 (1.6–10.1); and leucocyte count 16,100 per mcl, OR 3.5 (1.6–7.6). Conclusions The cut-off values for SIRS variables did not differ between healthy and infected obstetric patients. However, a higher cut-off may help predict the population with a higher risk of severe maternal outcomes.

scholarly journals L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty

2011 ◽  
Vol 26 (suppl 1) ◽  
pp. 72-76 ◽  
Author(s):  
José Ferreira da Cunha Filho ◽  
Isabelle Ivo Gonçalves ◽  
Sergio Botelho Guimarães ◽  
Francisco Vagnaldo Fechine Jamacaru ◽  
José Huygens Parente Garcia ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Inflammatory Response ◽  
Surgical Procedure ◽  
Infusion Pump ◽  
Venous Blood ◽  
Thiobarbituric Acid ◽  
Saline Control ◽  
Control Group ◽  
Group A ◽  
Group B

PURPOSE: To evaluate the effects of L-alanyl-glutamine (L-Ala-Gln) pretreatment on oxidative stress, glycemic control and inflammatory response in children submitted to palatoplasty. METHODS: Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 groups (n=15): Group A (saline, control) and Group B (L-Ala-Gln). Group A received normal saline 100 ml, delivered intravenously by infusion pump over 3 hours preceding surgical procedure. Group B was treated with L-Ala-Gln, 20% solution (0.5g/Kg), adding saline to complete 100ml. Peripheral venous blood samples were collected at 5 different time-points: T1- at the beginning of the study, 3 h prior to the surgical procedure; T2- at the end of the infusion (before the surgical procedure), T3- at the end of the surgical procedure, T4- 6 h postoperative and T5- 12 h postoperative. Parameters analyzed included glutathione (GSH), thiobarbituric acid reactive substances (TBARS), glucose, insulin, C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS: No statistically significant differences were found between groups comparing glucose, insulin, TBARS, GSH and IL-6 levels. However, glucose levels increased (P <0.001) in T4 and T5 as compared to baseline (T1) in control group as opposed to L-Ala-Gln group. IL-6 increased in both groups during the postoperative period, indicating an increased inflammatory response. L-Ala-Gln pretreatment did not suppress the increase of IL-6, but reduced the increase of postoperative CRP levels (T5, p <0.01). CONCLUSION: Pretreatment with L-Ala-Gln in children submitted to palatoplasty attenuates the inflammatory response in early post-operative period and promoted a better glycemic control.

scholarly journals A panel of urine-derived biomarkers to identify sepsis and distinguish it from systemic inflammatory response syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yao Tang ◽  
Ning Ling ◽  
Shiying Li ◽  
Juan Huang ◽  
Wenyue Zhang ◽  
...  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Systemic Inflammatory Response ◽  
Urine Samples ◽  
Sepsis Group ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Healthy Control ◽  
Group A

AbstractSepsis is a potentially fatal condition caused by infection. It is frequently difficult to distinguish sepsis from systemic inflammatory response syndrome (SIRS), often resulting in poor prognoses and the misuse of antibiotics. Hence, highly sensitive and specific biomarkers are needed to differentiate sepsis from SIRS. Urine samples were collected and segregated by group (a sepsis group, a SIRS group, and a healthy control group). iTRAQ was used to identify the differentially expressed proteins among the three groups. The identified proteins were measured by ELISA in urine samples. Finally, all the acquired data were analyzed in SPSS. C-reactive protein, leucine-rich alpha glycoprotein-1 and serum amyloid A (SAA) protein were differentially expressed among the three groups. The adjusted median concentrations of urinary C-reactive protein were 1337.6, 358.7, and 2.4 in the sepsis, SIRS, and healthy control groups, respectively. The urinary leucine-rich alpha glycoprotein-1 levels in these three groups were 1614.4, 644.5, and 13.6, respectively, and the levels of SAA were 6.3, 2.9, and 0.07, respectively. For all three of these measures, the sepsis group had higher levels than the SIRS group (P < 0.001), and the SIRS group had higher levels than the healthy control group. When combined, the three biomarkers had a sensitivity of 0.906 and a specificity of 0.896 in distinguishing sepsis from SIRS. Urinary C-reactive protein, urinary leucine-rich alpha glycoprotein-1 and urinary SAA have diagnostic value in cases of sepsis. This initial study suggests the possibility of improved differential diagnosis between sepsis and systemic inflammatory response syndrome; additional confirmation is necessary to corroborate the findings.

Prospective Study of Incidence and Severity of Epiphora and Canalicular Stenosis in Patients With Metastatic Breast Cancer Receiving Docetaxel

2006 ◽  
Vol 24 (22) ◽  
pp. 3619-3622 ◽  
Author(s):  
Bita Esmaeli ◽  
Sapna Amin ◽  
Vicente Valero ◽  
Rosnie Adinin ◽  
Rebecca Arbuckle ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Prospective Trial ◽  
Metastatic Breast ◽  
Weekly Docetaxel ◽  
Ophthalmologic Examination ◽  
Silicone Intubation ◽  
Canalicular Stenosis ◽  
Weekly Group ◽  
Lacrimal Drainage

Purpose To determine the incidence and severity of epiphora and canalicular stenosis in patients receiving docetaxel weekly or every 3 weeks. Patients and Methods In this prospective trial, each patient underwent an ophthalmologic examination and probing and irrigation of the lacrimal drainage apparatus at baseline and every 4 to 6 weeks after initiation of docetaxel. During each visit, epiphora and canalicular stenosis were graded. Patients with epiphora were treated with tobramycin and dexamethasone drops. If epiphora worsened or if findings on probing and irrigation suggested further canalicular narrowing, silicone intubation was offered. Results Twenty-eight patients received docetaxel weekly, and 28 patients received docetaxel every 3 weeks. Eighteen patients (64%) who received weekly docetaxel developed epiphora. Epiphora was mild in seven patients, moderate in five, and severe in six. Nine patients had resolution of epiphora with tobramycin and dexamethasone administration. Nine patients had worsened canalicular stenosis; six underwent surgery. The median cumulative docetaxel dose was 496.5 mg at onset of epiphora and 889.5 mg at surgery. Eleven patients (39%) who received docetaxel every 3 weeks developed epiphora. The median cumulative docetaxel dose at onset of epiphora in this group was 420 mg. Epiphora was mild in nine patients, moderate in one, and severe in one. Nine patients had resolution of epiphora with tobramycin and dexamethasone administration. Two patients underwent surgery. Conclusion Epiphora occurred in 64% of patients in the weekly group and in 39% of patients in the every-3-weeks group. Moderate or severe canalicular stenosis was seen in about one-third of patients in the weekly group and in none of the patients in the every-3-weeks group.

scholarly journals Estimation of Eyelid Pressure Using a Blepharo-Tensiometer in Patients with Functional Nasolacrimal Duct Obstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Jinsoo Kim ◽  
Sang-Mok Lee ◽  
Youn Joo Choi ◽  
Min Joung Lee
Keyword(s):  
Diagnostic Value ◽  
Lower Eyelid ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Control Group ◽  
Duct Obstruction ◽  
Silicone Intubation ◽  
The Difference ◽  
The Relationship

Purpose. To compare the eyelid pressure between patients with functional nasolacrimal duct obstruction (FNLDO) and normal controls using blepharo-tensiometer, and to evaluate the relationship between eyelid pressure and the outcomes of silicone intubation (SI) in patients with FNLDO. Study design. Prospective case-control study. Methods. We enrolled 36 eyes of 36 patients with suspected FNLDO who underwent SI and 36 healthy eyes of age-matched controls. One eye of each patient with FNLDO was randomly selected for analysis. The eyelid pressure was estimated using a blepharo-tensiometer and compared between the control and FNLDO groups. The relationship between eyelid pressure and clinical variables was analyzed. The outcomes of SI were assessed at 6 months after surgery using subjective and objective criteria. Results. The eyelid pressure was significantly lower in the FNLDO group than in the control group P=0.008. In the control group, the eyelid pressure was correlated with age P<0.001 and lower eyelid laxity P=0.016. In the FNLDO group, the eyelid pressure was only correlated with age P<0.001. The success rate of SI for FNLDO was 69.4% (25 of 36 eyes). The eyelid pressure was higher in the surgical success subgroup than in the failure subgroup, although the difference was not statistically significant P=0.08. Conclusions. Our results suggest that the eyelid pressure measured using a blepharo-tensiometer has a diagnostic value since it is decreased in patients with FNLDO. The role of eyelid pressure as a possible predictor of the outcomes of SI for FNLDO should be investigated in further studies. This trial is registered with KCT0002828.

scholarly journals Characteristics of the clinical forms and optimization of treatment of dacryocystitis in the newborns

2012 ◽  
Vol 93 (1) ◽  
pp. 85-88
Author(s):  
G Z Galeeva ◽  
A N Samoylov ◽  
L T Musina ◽  
E I Russkikh
Keyword(s):  
Surgical Treatment ◽  
Antimicrobial Agents ◽  
Nasolacrimal Duct ◽  
Lysozyme Activity ◽  
Control Group ◽  
Pathogenic Microorganisms ◽  
Microbiological Investigation ◽  
The Third ◽  
Causative Agents ◽  
Microbial Etiology

Aim. To optimize the treatment of dacryocystitis in the newborns, to reduce the frequency of recurrent nasolacrimal duct catheterization. Methods. Examined were 207 children suffering from catarrhal (the first group - 57 children, 73 affected eyes), purulent (the second group - 139 children, 158 eyes) and phlegmonous (the third group - 11 children, 12 eyes) dacryocystitis. A control group was also formed - 12 children without inflammatory eye diseases. Conducted was a clinical examination, determined was the lysozyme activity of the tears, analyzed was the effectiveness of medicinal and surgical treatment, and conducted was a microbiological investigation with the study of sensitivity of the pathogenic microorganisms to antibacterial drugs. Results. In catarrhal dacryocystitis of the newborns identified were seven species of microorganisms, most commonly found were S. epidermidis (more than 50%) and S. aureus (12.4%), in 19.2% of cases no pathogen was identified. The etiology of purulent dacryocystitis was more diverse - 23 species of pathogens, the leading pathogens were S. aureus (15.2%), S. pneumoniae and S. epidermidis (13.9% each), E. faecium (8.2%). In the phlegmonous form of the disease revealed were 4 types of pathogens, most commonly S. epidermidis (45.5%) and S. aureus (27.2%). In 9.1% of cases no pathogen was identified. The causative agents of catarrhal and purulent dacryocystitis of the newborns showed the greatest sensitivity to pikloxydine (100% and 93.3%), chloramphenicol (86.7% and 79.7%) and ciprofloxacin (87.0% and 72.2%). Revealed was the reduction of lysozyme activity of the tears both in the affected and in the unaffected eyes of children with dacryocystitis. During the analysis of the results of surgical treatment the frequency of relapses in the first group (catarrhal dacryocystitis of the newborns) was 8.3%, while in the second group (purulent dacryocystitis) it was significantly higher - 13.7%. Conclusion. In order to reduce the frequency of relapses conservative treatment should be conducted with respect to the microbial etiology, forms of the disease, and sensitivity of pathogens to antimicrobial agents before catheterization of the nasolacrimal duct.

Silicone Intubation as an Alternative to Dacryocystorhinostomy for Nasolacrimal Drainage Obstruction in Adults

1993 ◽  
Vol 3 (2) ◽  
pp. 71-76 ◽  
Author(s):  
K. Psilas ◽  
V. Eftaxias ◽  
J. Kastanioudakis ◽  
C. Kalogeropoulos
Keyword(s):  
Success Rate ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Silicone Tube ◽  
Duct Obstruction ◽  
Silicone Tubing ◽  
Chronic Dacryocystitis ◽  
Silicone Intubation ◽  
Lacrimal Drainage

Silicone tubing was used to repair the patency of the nasolacrimal drainage system in 115 patients (four bilaterally) with chronic nasolacrimal duct obstruction. The patients were over 20 years old and 16 were men and 99 women; 46% presented an uncomplicated obstruction with epiphora and 54% presented additional signs of chronic dacryocystitis. We used the technique of Quickert and Dryden with modifications. The silicone tube remained for a mean of 5.5 months (± 2.5 SD). After removal of the tube the follow-up ranged from 6 to 42 months (mean ± SD: 16 ± 9). Patency was maintained in 89% of cases with uncomplicated obstruction and in 69% of those with chronic dacryocystitis (total success rate 78%). We can therefore recommend silicone intubation of the lacrimal drainage system as an alternative to dacryocystorhinostomy (DCR), in adults with obstruction of the nasolacrimal duct. In addition, unlike DCR this technique is bloodless and the operation takes less time.

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