Variation of the minimally invasive CDCR technique

Austin Pharo, James Chelnis, Tara Goecks, Kendra C. DeAngelis, Brian Fowler, James Fleming, Thomas C. Naugle

Research output: Contribution to journalArticle

Abstract

Purpose: Traditional (tCDCR) and endoscopic conjunctivodacryocystorhinostomy (eCDCR) are challenging surgical techniques requiring general anesthesia, a facial incision, and a large osteotomy and mucosal flap. Minimally invasive CDCR (miCDCR) techniques eliminate the need for some of the steps in t/eCDCR. Introduced here is a variation of the miCDCR technique using a Naugle-Fleming knurled dilator (NKD) to create the osteotomy and instruments within a central line catheter kit to help easily place or replace a Jones’ tube into position within a bony conduit. Methods: This IRB-approved retrospective chart review examined all patients who underwent this miCDCR technique performed by two oculoplastic surgeons at Hamilton Eye Institute at the University of Tennessee Health Sciences Center from 2014 to 2016. Inclusion criteria: need for CDCR (either primary or repeat). Exclusion criteria: loss to follow up prior to six months. Primary endpoints: operative time, incidence of tube migration and complications, and cessation of epiphora. Results: Sixteen patients (nine men, seven women) were reviewed, with three undergoing bilateral procedure, totaling 19 cases. Age range: 47.0 to 84.0 years, average of 66.6 years (SD = 11.1). Ten patients had surgery under local/MAC augmented with IV sedation, and six had general anesthesia (38%). Average operative time was 17.4 min (SD = 10.9). One patient (5%) required revision in the six-month immediate post-operative period because of tube migration. All patients had cessation of epiphora. Conclusions: This procedure can be done safely and quickly without general anesthesia, resulting in a satisfactorily lower rate of tube migration and cessation of epiphora rates.

Original languageEnglish (US)
JournalOrbit (London)
DOIs
StatePublished - Jan 1 2019

Fingerprint

Lacrimal Apparatus Diseases
General Anesthesia
Operative Time
Osteotomy
Research Ethics Committees
Catheters
Incidence
Health

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Pharo, A., Chelnis, J., Goecks, T., DeAngelis, K. C., Fowler, B., Fleming, J., & Naugle, T. C. (2019). Variation of the minimally invasive CDCR technique. Orbit (London). https://doi.org/10.1080/01676830.2019.1605612

Variation of the minimally invasive CDCR technique. / Pharo, Austin; Chelnis, James; Goecks, Tara; DeAngelis, Kendra C.; Fowler, Brian; Fleming, James; Naugle, Thomas C.

In: Orbit (London), 01.01.2019.

Research output: Contribution to journalArticle

Pharo, A, Chelnis, J, Goecks, T, DeAngelis, KC, Fowler, B, Fleming, J & Naugle, TC 2019, 'Variation of the minimally invasive CDCR technique', Orbit (London). https://doi.org/10.1080/01676830.2019.1605612
Pharo, Austin ; Chelnis, James ; Goecks, Tara ; DeAngelis, Kendra C. ; Fowler, Brian ; Fleming, James ; Naugle, Thomas C. / Variation of the minimally invasive CDCR technique. In: Orbit (London). 2019.
@article{e6d5a3832e884c0f8dd7ad0163a56242,
title = "Variation of the minimally invasive CDCR technique",
abstract = "Purpose: Traditional (tCDCR) and endoscopic conjunctivodacryocystorhinostomy (eCDCR) are challenging surgical techniques requiring general anesthesia, a facial incision, and a large osteotomy and mucosal flap. Minimally invasive CDCR (miCDCR) techniques eliminate the need for some of the steps in t/eCDCR. Introduced here is a variation of the miCDCR technique using a Naugle-Fleming knurled dilator (NKD) to create the osteotomy and instruments within a central line catheter kit to help easily place or replace a Jones’ tube into position within a bony conduit. Methods: This IRB-approved retrospective chart review examined all patients who underwent this miCDCR technique performed by two oculoplastic surgeons at Hamilton Eye Institute at the University of Tennessee Health Sciences Center from 2014 to 2016. Inclusion criteria: need for CDCR (either primary or repeat). Exclusion criteria: loss to follow up prior to six months. Primary endpoints: operative time, incidence of tube migration and complications, and cessation of epiphora. Results: Sixteen patients (nine men, seven women) were reviewed, with three undergoing bilateral procedure, totaling 19 cases. Age range: 47.0 to 84.0 years, average of 66.6 years (SD = 11.1). Ten patients had surgery under local/MAC augmented with IV sedation, and six had general anesthesia (38{\%}). Average operative time was 17.4 min (SD = 10.9). One patient (5{\%}) required revision in the six-month immediate post-operative period because of tube migration. All patients had cessation of epiphora. Conclusions: This procedure can be done safely and quickly without general anesthesia, resulting in a satisfactorily lower rate of tube migration and cessation of epiphora rates.",
author = "Austin Pharo and James Chelnis and Tara Goecks and DeAngelis, {Kendra C.} and Brian Fowler and James Fleming and Naugle, {Thomas C.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1080/01676830.2019.1605612",
language = "English (US)",
journal = "Orbit",
issn = "0167-6830",
publisher = "Informa Healthcare",

}

TY - JOUR

T1 - Variation of the minimally invasive CDCR technique

AU - Pharo, Austin

AU - Chelnis, James

AU - Goecks, Tara

AU - DeAngelis, Kendra C.

AU - Fowler, Brian

AU - Fleming, James

AU - Naugle, Thomas C.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Traditional (tCDCR) and endoscopic conjunctivodacryocystorhinostomy (eCDCR) are challenging surgical techniques requiring general anesthesia, a facial incision, and a large osteotomy and mucosal flap. Minimally invasive CDCR (miCDCR) techniques eliminate the need for some of the steps in t/eCDCR. Introduced here is a variation of the miCDCR technique using a Naugle-Fleming knurled dilator (NKD) to create the osteotomy and instruments within a central line catheter kit to help easily place or replace a Jones’ tube into position within a bony conduit. Methods: This IRB-approved retrospective chart review examined all patients who underwent this miCDCR technique performed by two oculoplastic surgeons at Hamilton Eye Institute at the University of Tennessee Health Sciences Center from 2014 to 2016. Inclusion criteria: need for CDCR (either primary or repeat). Exclusion criteria: loss to follow up prior to six months. Primary endpoints: operative time, incidence of tube migration and complications, and cessation of epiphora. Results: Sixteen patients (nine men, seven women) were reviewed, with three undergoing bilateral procedure, totaling 19 cases. Age range: 47.0 to 84.0 years, average of 66.6 years (SD = 11.1). Ten patients had surgery under local/MAC augmented with IV sedation, and six had general anesthesia (38%). Average operative time was 17.4 min (SD = 10.9). One patient (5%) required revision in the six-month immediate post-operative period because of tube migration. All patients had cessation of epiphora. Conclusions: This procedure can be done safely and quickly without general anesthesia, resulting in a satisfactorily lower rate of tube migration and cessation of epiphora rates.

AB - Purpose: Traditional (tCDCR) and endoscopic conjunctivodacryocystorhinostomy (eCDCR) are challenging surgical techniques requiring general anesthesia, a facial incision, and a large osteotomy and mucosal flap. Minimally invasive CDCR (miCDCR) techniques eliminate the need for some of the steps in t/eCDCR. Introduced here is a variation of the miCDCR technique using a Naugle-Fleming knurled dilator (NKD) to create the osteotomy and instruments within a central line catheter kit to help easily place or replace a Jones’ tube into position within a bony conduit. Methods: This IRB-approved retrospective chart review examined all patients who underwent this miCDCR technique performed by two oculoplastic surgeons at Hamilton Eye Institute at the University of Tennessee Health Sciences Center from 2014 to 2016. Inclusion criteria: need for CDCR (either primary or repeat). Exclusion criteria: loss to follow up prior to six months. Primary endpoints: operative time, incidence of tube migration and complications, and cessation of epiphora. Results: Sixteen patients (nine men, seven women) were reviewed, with three undergoing bilateral procedure, totaling 19 cases. Age range: 47.0 to 84.0 years, average of 66.6 years (SD = 11.1). Ten patients had surgery under local/MAC augmented with IV sedation, and six had general anesthesia (38%). Average operative time was 17.4 min (SD = 10.9). One patient (5%) required revision in the six-month immediate post-operative period because of tube migration. All patients had cessation of epiphora. Conclusions: This procedure can be done safely and quickly without general anesthesia, resulting in a satisfactorily lower rate of tube migration and cessation of epiphora rates.

UR - http://www.scopus.com/inward/record.url?scp=85066069732&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066069732&partnerID=8YFLogxK

U2 - 10.1080/01676830.2019.1605612

DO - 10.1080/01676830.2019.1605612

M3 - Article

JO - Orbit

JF - Orbit

SN - 0167-6830

ER -