The aim of this meta-analysis is to compare the surgical results of endoscopic dacryocystorhinostomy (Endo-DCR) for chronic dacryocystitis (CD) with and without intraoperative hyaluronic acid (HA) application.
Methods
An electronic literature search was performed using the PubMed, Embase, Cochrane Library, CNKI, and Wan Fang databases in April 1, 2022. Review Manager software version 5.4 was used for data synthesis and a forest plot was generated for each outcome measure.
Results
Seven randomized control trials (RCTs), which involved 739 eyes, were included in this meta-analysis. Overall, compared with the control group, intraoperative HA application significantly enhance the success rate (odds ratio [OR] = 3.27, 95% confidence interval [CI]: 2.15–4.98, P < .00001), promote re-epithelization (OR = 2.93, 95% CI: 1.83–4.68, P < .00001), reduce granulation (OR = 0.41, 95% CI: 0.21–0.80, P = .008), and scar (OR = 0.39, 95% CI: 0.22–0.68, P = .001) formation after Endo-DCR.
Conclusion
Intraoperative HA application seems to be a useful adjuvant that could enhance success rate by promoting re-epithelization and inhabiting granulation and scar formation around the ostium.
EldsokyIIsmaielWFHasanA, et al. The predictive value of nasolacrimal sac biopsy in endoscopic dacryocystorhinostomy. Ann Med Surg (Lond). 2021;65:102317.
4.
LuoBLiMXiangN, et al. The microbiologic spectrum of dacryocystitis. BMC Ophthalmol. 2021;21(1):29.
MakselisAPetroskaDKadziauskieneA, et al. Acquired nasolacrimal duct obstruction: Clinical and histological findings of 275 cases. BMC Ophthalmol. 2022;22(1):12.
7.
SavinoGBattendieriRTrainaS, et al. External vs. endonasal dacryocystorhinostomy: Has the current view changed?Acta Otorhinolaryngol Ital. 2014;34(1):29–35.
GrobSRCampbellALefebvreDR, et al. External versus endoscopic endonasal dacryocystorhinostomy. Int Ophthalmol Clin. 2015;55(4):51–62.
10.
SaeedBM. Endoscopic DCR: A 10 years personal experience. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 3):2039–2043.
11.
KarimRGhabrialRLynchT, et al. A comparison of external and endoscopic endonasal dacryocystorhinostomy for acquired nasolacrimal duct obstruction. Clin Ophthalmol. 2011;5:979–989.
12.
CohenOAmosIHalperinD, et al. Five- and 10-year outcomes for primary endoscopic dacryocystorhinostomy: Failure rate and risk factors. Laryngoscope. 2021;131(1):10–16.
13.
KerenSAbergelAManorA, et al. Endoscopic dacryocystorhinostomy: Reasons for failure. Eye (Lond). 2020;34(5):948–953.
14.
ZlotoOKovalTYakirevichA, et al. Endoscopic dacryocystorhinostomy with and without mucosal flap-is there any difference?Eye (Lond). 2020;34(8):1449–1453.
15.
KangMGShimWSShinDK, et al. A systematic review of benefit of silicone intubation in endoscopic dacryocystorhinostomy. Clin Exp Otorhinolaryngol. 2018;11(2):81–88.
16.
KumarSMishraAKSethiA, et al. Comparing outcomes of the standard technique of endoscopic DCR with its modifications: A retrospective analysis. Otolaryngol Head Neck Surg. 2019;160(2):347–354.
17.
DalgicACeylanMEÇelikÇ, et al. Outcomes of endoscopic powered revision dacryocystorhinostomy. J Craniofac Surg. 2018;29(7):1960–1962.
18.
ParkJLeeJJangS, et al. Effectiveness of sodium hyaluronate (protad) application in endoscopic endonasal dacryocystorhinostomy. Can J Ophthalmol. 2017;52(2):192–197.
19.
ChenJWangXChenL, et al. Influence of hyaluronan nasal dressing on clinical outcome after endoscopic sinus surgery: A systematic review and meta-analysis. Am J Rhinol Allergy. 2017;31(4):256–259.
20.
WuWCannonPSYanW, et al. Effects of merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis. Eye (Lond). 2011;25(6):746–753.
21.
YuBTuYZhouG, et al. Self-Cross-Linked hyaluronic acid hydrogel in endonasal endoscopic dacryocystorhinostomy: A randomized, controlled trial. J Craniofac Surg. 2021;32(5):1942–1945.
22.
LiuCWeiPCHuJW. Three kinds of medicine in dacryocystorhinostomy. J Otolaryngol Ophthalmol Shandong Univ. 2011;25(6):58–61.
23.
MengJDuJTLiuYF. Effect of medical self-crosslinked sodium hyaluronic gel on intranasal endoscopic dacryocystorhinostomy. Sichuan Medical Journal. 2015;36(12):1617–1619.
24.
QinLLQinHYinYQ, et al. Clinical effect of two types of hemostatic materials in endonasal endoscopic dacryocystorhinostomy: A comparative analysis. Acta Academiae Medicinae Qingdao Universitatis. 2017;53(6):697–700.
25.
WangJPZhangDXMaY, et al. Observation of sodium hyaluronate in routine dacryocystorhinostomy. Int J Ophthalmol. 2009;9(7):1307–1309.
26.
WangYYeLPengY, et al. The application of a new nasal dressing in entranasal endoscopic dacryocystorhinostomy. Chin J Ocul Traum Occupat Eye Dis. 2016;38(2):100–104.
27.
WenHYWangRLiuMX, et al. Clinical observation of endoscopic dacryocystostomy combined with merogel filling for treatment of chronic dacryocystitis. Chinese Community Doctors. 2019;35(26):57–58.
28.
ApuhanTYıldırımYSErogluFSipahierA. Effect of mitomycin C on endoscopic dacryocystorhinostomy. J Craniofac Surg. 2011;22(6):2057–2059.
29.
Al-QahtaniAS. Primary endoscopic dacryocystorhinostomy with or without silicone tubing: A prospective randomized study. Am J Rhinol Allergy. 2012;26(4):332–334.
30.
FongEGarciaMWoodsCM, et al. Hyaluronic acid for post sinus surgery care: Systematic review and meta-analysis. J Laryngol Otol. 2017;131(S1):S2–S11.
31.
WooKIMaengHSKimYD. Characteristics of intranasal structures for endonasal dacryocystorhinostomy in asians. Am J Ophthalmol. 2011;152(3):491–498.
