HAMMER CHIESEL TECHNIQUE IN ENDOSCOPIC DACRYOCYSTORHINOSTOMY
Yasar ÇOKKESER, M.D.* Cem EVEREKLİOĞLU, M.D.** Mustafa TERCAN, M.D.*** İbrahim F. HEPŞEN, M.D.** Hüseyin BAYRAMLAR, M.D.** Davut AKTAŞ, M.D.*
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Abstract
Background: Endoscopic dacryocystorhinostomy (DCR) gained wide acceptance, with a comperable success to external DCR. Removal of sufficient bone over the lacrimal sac
in endoscopic DCR is crucial in obtaining a permanent rhinostoma. Several different methods utilized to accomplish this goal.
Aims: To describe the technique using hammer-chisel endoscopically for removal of bone over the lacrimal sac. Advantages and shortcomings of this technique were
discussed in the light of literatüre.
Methods: Prospective evaluation of endoscopic hammer-chisel DCR performed on 56 eyes of 40 patients with chronic epiphora or dacryocystitis were evaluated (24 unilateral and 16 biiateral, 36 female and 4 maie). Hammer-chiesel endoscopic DCR technique included chiesel removal of the bone located over the lacrimal sac. Preoperative intra or postoperative findings and follow-up rewieved and discussed.
Results: Follow-up period was 6 to 48 months (mean, 22) postoperatively. Success rate of consecutive endoscopic hammer-chisel DCR was 87.7%. Intraoperatively, 8 cases showing miid mucosal haemorrhage which neither prevented a successful completLon of operatLon. Excellent patLent tolerance wLth mLnLmal morbLdLty and no major compiication was observed.
Conclusions: Endoscopic Hammer-chisel DCR is less traumatic and practical with minimal per and postoperative compiications. It requires minimal instrumentation and is an easy and fast technique.
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