Dacryocystorhinostomy Ab Externo

master's thesis

• Title (croatian): Dakriocistorinostomija - vanjski pristup
• Author: Zohar Yamin
• Mentor: Jelena Juri Mandić (mentor)
• Committee member: Jelena Juri Mandić (predsjednik povjerenstva)
• Committee member: Nenad Vukojević (član povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

External dacryocystorhinostomy (DCR) surgery is a widely employed procedure in ophthalmology for the treatment of nasolacrimal duct obstruction (NLDO). This surgical intervention involves modifying the nasal anatomy to restore the normal drainage of tears. Two primary techniques are utilized: the external approach and the endoscopic approach.
The external approach, considered the gold standard in DCR surgery, offers distinct advantages owing to its comprehensive visualization of the involved anatomy. This method requires a creation of small incision in the lateral aspect of the nose, providing direct access to the nasolacrimal system. The surgeon benefits from a clear and unobstructed view, facilitating precise identification and removal of any possible obstructive material within the lacrimal sac. Consequently, the external approach ensures a higher likelihood of successful outcomes.
Moreover, the external approach permits optimal exposure of the lacrimal sac and nasal bone, which may necessitate manipulation during the procedure. This unimpeded access enables meticulous intervention, ensuring thorough eradication of pathological elements and promoting favorable postoperative results.
Furthermore, the external approach is particularly advantageous in cases necessitating revision surgery or those characterized by complex anatomical variations. It enables the surgeon to navigate through scar tissue or previous surgical alterations, facilitating meticulous correction of the lacrimal drainage.
While the endoscopic approach has gained popularity due to its minimally invasive nature, it may not be universally applicable. The limited visualization and restricted access inherent to the endoscopic technique may impede the surgeon's ability to execute precise adjustments and address intricate anatomical anomalies.

Abstract (croatian)

Dakriocistorinostomija Vanjski Pristup (DCR) široko je korišten postupak u oftalmologiji za liječenje obstrukcije suznog aparata. Ova kirurška intervencija uključuje modificiranje nosne anatomije kako bi se uspostavila normalna drenaža suza. Koriste se dvije osnovne tehnike: vanjski pristup i endoskopski pristup.
Vanjski pristup, koji se smatra zlatnim standardom u vanjskoj DCR kirurgiji, nudi različite prednosti zahvaljujući sveobuhvatnoj vizualizaciji nazalne anatomije. Ova metoda podrazumijeva formiranje malog reza u medijalnom očnom kutu, čime se omogućuje izravan pristup proksimalnom dijelu suznog puta. Kirurg ima koristi od jasnog i neometanog pogleda, olakšavajući preciznu identifikaciju i uklanjanje eventualne opstruktivne lezije unutar suzne vrečice. Posljedično, vanjski pristup osigurava veću vjerojatnost uspješnih ishoda.
Štoviše, vanjski pristup omogućuje optimalno izlaganje suzne vrećice i nosne kosti, što može zahtijevati manipulaciju tijekom postupka. Taj nesmetan pristup omogućuje minucioznu intervenciju, osiguravajući temeljito iskorjenjivanje patoloških elemenata i pospješujući povoljne postoperativne rezultate.
Nadalje, vanjski pristup posebno je koristan u slučajevima koji zahtijevaju revizjuili kod onih koje karakteriziraju složene anatomske varijacije. Kirurgu se tim pristupom olakšava navigacija kroz ožiljno tkivo ili uzrokovane prethodnim kirurškim intervencijama, olakšavajući precizno uspostavljanje novog puta za drenažu suza.
Iako je endoskopski pristup stekao popularnost zbog svoje minimalno invazivne prirode, nije univerzalno primjenjiv. Ograničena vizualizacija i ograničeni pristup svojstveni endoskopskoj tehnici mogu spriječiti kirurgovu sposobnost da izvrši precizne prilagodbe i riješi zamršene anatomske anomalije.

• Keywords: Dacryocystorhinostomy; Lacrimal Duct Obstruction; Nasolacrimal Duct; Nasal Bone
• Keywords (croatian): Dakriocistorinostomija; opstrukcija suznog kanala; nazolakrimalni kanal; nosna kost
• Language: english
• URN:NBN: urn:nbn:hr:105:351979
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-10-21 09:14:56