The Influence of a Silicone Tube on Tear Drainage in Patients with Healed Rhinostomy after Dacryocystorhinostomy

Abstract

Purpose: To evaluate the influence of a silicone tube on tear drainage in patients with a healed rhinostomy site after dacryocystorhinostomy.

Methods: The subjects of the present study included the patients for whom the removal of a silicone tube was performed after dacryocystorhinostomy for acquired nasolacrimal duct obstruction. The silicone tube was removed after the rhinostomy site was completely healed. The tear drainage function was evaluated using the fluorescein dye disappearance test at the following 3 time points: immediately before, immediately after, and 1 month after silicone tube removal. In addition, a Schirmer test was performed and tear break-up time was measured at each time point. To study the correlation between the measured values and subjective tearing symptoms, self-report questionnaires were given to each patient at his/her last visit.

Results: The 3 measured values showed no statistical difference between the 3 time points, immediately before, immediately after, and 1 month after silicone tube removal. When the patients were divided into groups according to their subjective symptomatic changes after silicone tube removal, no group showed statistically significant difference in the 3 measured values before, between, and after silicone tube removal.

Conclusions: In patients with a healed rhinostomy site after dacryocystorhinostomy, the removal of the silicone tube did not induce a change of tear drainage function. Therefore, based on the results from the present study, a silicone tube may not have influence on tear drainage functions.

목적: 눈물주머니코안연결술 및 실리콘관 삽입술 후 창상회복이 완료된 환자에서 관의 존재가 눈물배출에 미치는 영향 여부를 밝히고 자 하였다.

대상과 방법: 원발 후천 코눈물관폐쇄로 코경유 눈물주머니코안연결술 및 실리콘관 삽입술을 시행 받은 환자에서 창상회복이 완료되어 관을 제거함에 있어 제거 전, 제거 직후 그리고 제거 1개월 후에 염색약소실검사를 시행하였다. 또한 각 시기에 쉬르머검사와 눈물막파 괴시간 측정을 시행하였으며, 이러한 객관적 측정치와 환자의 주관적인 눈물흘림 증상 변화와의 연관성을 보기 위하여 최종 내원 시 설문 조사를 시행하였다.

결과: 눈물배출능, 쉬르머검사, 눈물막파괴시간 측정치 모두, 제거 전후 각 시점 간에 유의한 차이는 보이지 않았으며, 관 제거에 따른 주관적 증상 변화에 따라 환자군을 나누어 분석하였을 때도 세 측정치 모두 제거 전후에 유의한 차이는 없었다.

결론: 눈물주머니코안연결술 후 창상 회복이 완료된 환자에서 실리콘관의 제거가 환자의 눈물배출능 변화를 유발하지 않아, 이러한 환자들에서는 관의 존재가 눈물배출능에 미치는 유의한 영향은 없는 것으로 생각한다.