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Type: Journal article
Title: Acute post-operative rhinosinusitis following endonasal dacryocystorhinostomy
Author: Shams, P.
Selva-Nayagam, D.
Citation: Eye, 2013; 27(10):1130-1136
Publisher: Nature Publishing Group
Issue Date: 2013
ISSN: 0950-222X
Statement of
PN Shams and D Selva
Abstract: Purpose: To investigate the incidence and risk factors for acute rhinosinusitis (ARS) following endoscopic dacryocystorhinostomy (EnDCR). Methods: Retrospective single-surgeon interventional case series, including 196 consecutive patients undergoing 203 endonasal DCR, with clinical and radiological evidence of nasolacrimal duct or common canalicular obstruction. Pre-operative lacrimal and sinonasal clinical assessment and imaging, intraoperative endoscopic video recording, and post-operative clinical and endoscopic findings were analysed for cases of ARS occurring within the first 4 weeks following DCR among patients with and without a past history of chronic rhinosinusitis (CRS). Surgical complications and outcomes at 12 months and management of ARS are reported. Results: Three patients (1.5%) developed ARS within the first 5 post-operative days, none of which had experienced peri-operative complications and all had a past history of CRS. The rate of CRS in this cohort of 196 patients was 10.2% (n=20), of which 15% (n=3) developed ARS, although none had symptoms of CRS at the time of surgery; one had undergone previous sinus surgery. Presenting symptoms of ARS included facial pain, tenderness over the affected sinus, and nasal discharge; all patients responded to oral antibiotic therapy. Discussion: The rate of ARS following EnDCR was 1.5%. In those with a prior history of CRS, it was 15% (P=0.009). ARS developed within the first post-operative week among patients with a past history of CRS, who were asymptomatic at the time of surgery, and responded to oral antibiotics. CRS may be a risk factor for the development of post-operative ARS.
Keywords: endoscopic dacryocystorhinostomy
acute post-operative rhinosinusitis
chronic rhinosinusitis
nasolacrimal duct obstruction
functional endoscopic sinus surgery
Rights: © 2013 Macmillan Publishers Limited All rights reserved
DOI: 10.1038/eye.2013.147
Appears in Collections:Aurora harvest
Opthalmology & Visual Sciences publications

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