Оценка анатомической и функциональной состоятельности дакриостомы в послеоперационном периоде

Evaluation of the anatomical and functional viability of dacryocystorhinostomy ostium in the postoperative period

Introduction. Recurrence of dacryocystitis after dacryocystorhinostomy (DCR) via external, transcanalicular or endonasal approaches is most often associated with the occurrence of pathological processes in the area of the DCR ostium. Dynamic assessment of its condition is a key issue in postoperative period patient management. Aim. To develop a simple and convenient scale for assessing the DCR ostium condition for clinical use. Materials and methods. In the course of a prospective study, a dynamic observation of 54 patients (60 cases) was carried out after endoscopic endonasal DCR. The assessment was carried out using FICI scale by 4 parameters: fluorescein endoscopic dye test (FEDT), condition of the internal common opening (ICO), cicatricial processes in the DCR ostium, presence of pathological processes in the ICO area (synechiae, granulomas, membranes). Such parameters as the severity of pathological changes in the DCR ostium margins and the presence of a lacrimal implant were also taken into account. Observation was carried out at 2, 4, 8 and 12 weeks after DCR. Results. During the obtained data analysis the parameters that have the greatest impact on the anatomical and functional results of DCR were determined. A scoring system for assessing DCR ostium parameters was developed. With its help it is possible not only to standardize the approach to patient care after DCR, but also to timely assess the need for corrective surgical intervention in the postoperative period. Conclusion. A scale for assessing the state of the DCR ostium is proposed, which can be used to objectively assess the state of the DCR ostium and evaluate the need for repeated surgical intervention in order to improve the patency of the LD. This allows for a standardized approach to patient management in the postoperative period. The scoring system is easy to remember and allows for a short assessment of the state of the DS, which makes it convenient for use in everyday clinical practice. © Нерсесян МВ, Сурнина ЗВ, Краховецкий НН, Майданова АА, Попадюк ВИ, Галкина ТА, Жоголева ТН, 2025