Conditions for improving the effectiveness of surgical treatment of patients with chronic dacryocystitis in endonasal endoscopic procedures

Abstract

Introduction. Surgical treatment of patients with chronic dacryocystitis is a complex interdisciplinary problem. Lacrimal sac can be reached externally and internally (endonasally). The effectiveness of the treatment largely depends on the results of complete diagnosis and choice of a treatment method. Purpose. To analyze the effectiveness of surgical treatment of patients with chronic dacryocystitis in endonasal access. Materials and methods. The study of 225 patients consisted in the analysis of two groups of patients (20152019) with chronic dacryocystitis: the first group (110 patients) underwent an endonasal endoscopic dacryocystorhinostomy in the form of monooperation, the second underwent endonasal endoscopic dacryocystorhinostomy with additional intranasal interventions (115 patients). All patients underwent endoscopic examination of the nasal cavity and midface multispiral computed tomography (MSCT). Results. The results of the obtained data convincingly showed a higher efficiency of treatment in the group of patients with combined operations with the pathological processes revealed in intranasal localization in comparison with the group of monoperations. Conclusion. According to the study data, patients with chronic dacryocystitis should undergo full ophthalmologic and endonasal diagnostics, including multispiral computed tomography-dacryocystorhinography of the middle facial zone according to the described algorithm. When detecting pathological processes hindering the standard endonasal endoscopic dacryocystorhinostomy, it is necessary to perform an expanded scope of surgical interventions which will contribute to the efficiency of treatment of patients with chronic dacryocystitis up to 91.3%.