External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling

Vikram A Shankar,1 Krishna Kalyam,2 Steven M Couch2 1Department of Ophthalmology, Wills Eye Hospital, Philadelphia, PA, USA; 2Department of Ophthalmology, Washington University in St. Louis School of Medicine, St. Louis, MO, USACorrespondence: Steven M CouchDepartment of Ophthalmology, Washington Un...

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Autores principales:	Shankar VA, Kalyam K, Couch SM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	piezosurgery external dacryocystorhinostomy ultrasonic bone aspiration Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/8b98a24749ac40b3a56fa23a0fd802d4
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spelling	oai:doaj.org-article:8b98a24749ac40b3a56fa23a0fd802d42021-12-02T05:18:43ZExternal Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling1177-5483https://doaj.org/article/8b98a24749ac40b3a56fa23a0fd802d42019-12-01T00:00:00Zhttps://www.dovepress.com/external-dacryocystorhinostomy-a-comparison-of-ultrasonic-bone-aspirat-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Vikram A Shankar,1 Krishna Kalyam,2 Steven M Couch2 1Department of Ophthalmology, Wills Eye Hospital, Philadelphia, PA, USA; 2Department of Ophthalmology, Washington University in St. Louis School of Medicine, St. Louis, MO, USACorrespondence: Steven M CouchDepartment of Ophthalmology, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8096, St. Louis, MO 63110, USATel +1-314-996-3475Fax +1-314-996-8797Email CouchS@wustl.eduPurpose: Piezosurgical tools utilize high-frequency ultrasonic oscillations to selectively cut mineralized bone and minimize damage to soft tissue and mucosa. The purpose of this study was to directly compare outcomes in external dacryocystorhinostomy (DCR) using a piezoelectric ultrasonic bone aspirator (UBA) versus a high-speed electric drill with a diamond burr.Methods: A retrospective chart review was conducted on 145 consecutive patients who underwent external DCR by a single oculoplastic surgeon between 2012 and 2017. Collected data included baseline patient characteristics, presenting symptoms, operative details and complications, and postoperative symptoms.Results: One hundred and seventy-three primary external DCRs performed on 145 patients were included in this study. In total, 61.3% of cases were performed with the UBA and 38.7% with the high-speed drill. Most patients were white (92.4%) and female (67.6%), with a mean age of 57.6 years (range 1–93). Surgical success was achieved in 94.3% of patients in the UBA group and 94.0% in the drill group, with no significant differences between the two arms (p=0.36). Patients who experienced persistent nasolacrimal duct obstruction after surgery underwent endoscopic revision. Operative time was shortened for cases utilizing the UBA (38.9 mins) instead of the high-speed drill (44.7 mins; p=0.01). No significant intraoperative complications occurred in either group.Conclusion: The UBA offers comparable outcomes and complication rates to more conventional surgical tools for external DCR. Excellent outcomes, ease of adoption, and potential surgical time savings make the UBA an appealing option for both novice and experienced surgeons.Keywords: piezosurgery, external dacryocystorhinostomy, ultrasonic bone aspirationShankar VAKalyam KCouch SMDove Medical Pressarticlepiezosurgeryexternal dacryocystorhinostomyultrasonic bone aspirationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 2535-2540 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	piezosurgery external dacryocystorhinostomy ultrasonic bone aspiration Ophthalmology RE1-994
spellingShingle	piezosurgery external dacryocystorhinostomy ultrasonic bone aspiration Ophthalmology RE1-994 Shankar VA Kalyam K Couch SM External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling
description	Vikram A Shankar,1 Krishna Kalyam,2 Steven M Couch2 1Department of Ophthalmology, Wills Eye Hospital, Philadelphia, PA, USA; 2Department of Ophthalmology, Washington University in St. Louis School of Medicine, St. Louis, MO, USACorrespondence: Steven M CouchDepartment of Ophthalmology, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8096, St. Louis, MO 63110, USATel +1-314-996-3475Fax +1-314-996-8797Email CouchS@wustl.eduPurpose: Piezosurgical tools utilize high-frequency ultrasonic oscillations to selectively cut mineralized bone and minimize damage to soft tissue and mucosa. The purpose of this study was to directly compare outcomes in external dacryocystorhinostomy (DCR) using a piezoelectric ultrasonic bone aspirator (UBA) versus a high-speed electric drill with a diamond burr.Methods: A retrospective chart review was conducted on 145 consecutive patients who underwent external DCR by a single oculoplastic surgeon between 2012 and 2017. Collected data included baseline patient characteristics, presenting symptoms, operative details and complications, and postoperative symptoms.Results: One hundred and seventy-three primary external DCRs performed on 145 patients were included in this study. In total, 61.3% of cases were performed with the UBA and 38.7% with the high-speed drill. Most patients were white (92.4%) and female (67.6%), with a mean age of 57.6 years (range 1–93). Surgical success was achieved in 94.3% of patients in the UBA group and 94.0% in the drill group, with no significant differences between the two arms (p=0.36). Patients who experienced persistent nasolacrimal duct obstruction after surgery underwent endoscopic revision. Operative time was shortened for cases utilizing the UBA (38.9 mins) instead of the high-speed drill (44.7 mins; p=0.01). No significant intraoperative complications occurred in either group.Conclusion: The UBA offers comparable outcomes and complication rates to more conventional surgical tools for external DCR. Excellent outcomes, ease of adoption, and potential surgical time savings make the UBA an appealing option for both novice and experienced surgeons.Keywords: piezosurgery, external dacryocystorhinostomy, ultrasonic bone aspiration
format	article
author	Shankar VA Kalyam K Couch SM
author_facet	Shankar VA Kalyam K Couch SM
author_sort	Shankar VA
title	External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling
title_short	External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling
title_full	External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling
title_fullStr	External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling
title_full_unstemmed	External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling
title_sort	external dacryocystorhinostomy: a comparison of ultrasonic bone aspiration to high-speed drilling
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/8b98a24749ac40b3a56fa23a0fd802d4
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External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling

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