Probing and DCR

DCR و Probing

 

Nasolacrimal duct Surgery or DCR

Obstruction of the lacrimal duct that is caused by people suffering from tears and secretion of the affected eyes, the cause of this disease is not strictly known and there are different reasons for it, but the important thing is that in most of these individuals (more than 60% of cases) other anatomic and inflammatory problems There is a nose like a nasal septum diversion, nasal mucosa polyps, sinusitis or close proximity of the most anterior ethmoid sinus cell to the lacrimal duct or other problems. Experience has shown that during surgery, the nasolacrimal duct, where a new pathway is caused to drain the tear to the nose (dacryocystorrhinostomy) , if these problems are not resolved, the possibility of surgical failure is a further nasolacrimal duct

?What is the cause of obstruction of the nasolacrimal duct

In children, the obstruction of the lacrimal duct is mostly in a given form, and mostly with the massage of the lacrimal sac to one year, but in adults, especially in some middle-aged and old women, with an increase in age inflammation of the lacrimal duct due to inflammatory processes such as chronic nasal infection or inflammation Severe or chronic conjunctiva causes the lacrimal duct to be narrowed and eventually blocked. Sometimes fractures of the nasal or facial bones can cause mechanical obstruction of the lacrimal duct. Prolonged obstruction of the nasolacrimal duct usually results in a infection of the lacrimal sac

?What is the symptoms of nasolacrimal duct obstruction

Usually, patients with obstruction of the lacrimal duct, with the complaint of the tears of the eyes, and sometimes the withdrawal from the internal corner (the nasal side) of the eye are referred to Dr. Shahidi’s office. In these patients, the tears of the eye are chronic and permanent from the corner of the eyes of the sufferer, so that patients have to always, even when they are resting at home, they can dry the tears of the affected eye with a cloth. During the length of the nasolacrimal obstruction, sometimes the infection and acute inflammation of the lacrimal sac occur as a rigid and red swelling and very painful in the inner corner of the eye, between the eyes and the nose, which will require immediate treatment

?How can obstruction of the nasolacrimal duct be treated

Non-surgical treatment involves the consideration, massage of the lacrimal sac and the use of topical antibiotics. For massaging, you need to get your hand and put your pointing finger on the inner side (side) of the eye and press down. You may also be asked to use warm compresses. If you have infections, use a mrham or a topical antibiotic drop is beneficial

If the nasolacrimal duct obstruction is not resolved after a few months with the above treatment, or a severe infection occurs or your child has recurrent infections, it is necessary toprobing that 95-85% of cases are successful in children under one year but with increasing age of the child. L reduced success. The action of probing is a surgical procedure that lasts approximately 10 minutes and a single probe or a thin and metallic skewer is passed through the lacrimal duct to remove the blockage. Some doctors believe the age of probing is 6 months old that without General anesthesia is performed in the clinic, but some also believe probing to be delayed for one year to be given the maximum chance of opening the child’s own conduit. Probing is done in the operating room and under general anesthesia

Obstruction of the nasolacrimal duct is treatable only in the ages below two to three years, or in the term of the lacrimal duct, but at the higher ages, it is only a diagnostic aspect and is not recommended for treatment in any way. In adults, in order to treat the nasolacrimal duct obstruction, a surgical procedure called Purpose (DCR) is performed that the nasolacrimal duct is opened directly into the nose. Surgical procedure is used to achieve a small incision in the area between the eyes and the nose, on the skin of part B. You will be given a nose. Then a small piece of bone is removed between the lacrimal sac and the nose. At this stage, it is cut on the lacrimal sac and the cutting edges are sewn to the inner mucosa of the nose, which is a direct link between the lacrimal sac and the nose. Usually during this procedure, a silicone tube is also temporarily placed in the conduit to prevent the duct reocclusion after surgery. This pipe does not have pain and does not cause problems for the patient

Things that should be met before surgery

Given that up to forty hours after the operation, the water should be contacted by the place of injury, bathe the day before the operation. Given that the surgery is usually done under general anesthesia, you must be fasting (with a hungry abdomen) in the operating room, so at least eight hours before the surgery should be intact and drink no water. If you have high blood pressure, you will get spiking pressure pills in the morning with half a glassware of water. If you have a sugar disease and have a sugar pill, take the night before the operation of half the usual number of pills, and do not use blood sugar pills the morning

?What to do after the surgery

To a week after surgery, avoid bending head to bottom, and avoid eating and drinking hot liquids, because the failure to observe the above can lead to severe nosebleeds

To prevent bleeding from the nose, to twenty-four hours after surgery, tap the location of cold water compress or even ice compress. Considering that this surgery is usually accompanied by a lot of bleeding during surgery and even in one day after surgery, you have a good nutrition after surgery so that the body can replace and compensate for the lost blood and iron. If you have suffered severe nosebleeds after surgery, you will be admitted to a hospital emergency with ear and nasal facilities. Stitches are drawn one week after surgery and the place of action on the skin is also within 3 The moon fades in low. As long as the silicone tube is in the conduit, there may be little tears that will be removed by removing the pipe. Silkioni Tube 4 Up 6 The month after surgery is removed from inside the nose and without anesthesia or numbness. Possibility of successful treatment of  nasolacrimal duct obstruction with open surgical method (DCR) About Is 95%