The outcomes of surgical treatment in fistulous dacryocystitis.

BACKGROUND AND OBJECTIVES The aim of this study was to evaluate the outcomes of surgical management in fistulous dacryocystitis cases associated with nasolacrimal duct (NLD) obstruction. MATERIALS AND METHODS Twenty-two patients (14 female, 8 male) with fistulous dacryocystitis were included. The patients were divided into two groups as congenital (Group I) and acquired (Group II) groups. Fistula excision (FE) together with external dacryocystorhinostomy (DCR) and bicanalicular silicon tube (FCI Ophthalmics, Marshfield Hills, MA, USA) intubation (BSTI) were performed following medical therapy (Ofloxacin 0.3 % four times a day,intravenous cefazolin (50 mg/kg/day in children and 2 g/day in adults and gentamicin (5 mg/kg/day in children and 3 mg/kg/day in adults). The groups were compared with each other in terms of preoperative medical therapy duration, time of silicone tube extubation, follow-up time, and surgical outcomes. RESULTS Group I included five patients with acute dacryocystitis and seven patients with recurrent dacryocystitis following probing, whereas Group II was comprised of 8 acute dacryocystitis and two recurrent fistulous dacryocystitis. Mean length of preoperative medical therapy was 14.1±6.5 days for Group I and 11.9±2.5 days for Group II. Extubation of the silicone tube was performed after 4.5±1.2 months in Group I and after 4.6± 1.1 months in Group II. The patients were followed up for 13.5±4.8 months in Group I and 14.3±3.7 months in Group II. There was no significant difference between the two groups in length of preoperative medical therapy, time of extubation of the silicone tube, and follow-up time (p > 0.05). Postoperatively, patency of the nasolacrimal drainage system was verified by irrigation of the lacrimal ducts and use of fluorescein eye stain. In both groups, all patients underwent surgical treatment were treated successfully. CONCLUSIONS In fistulous dacryocystitis cases associated with the obstruction of NLD application of FE, external DCR treatment and BSTI appears as a valid surgical treatment option.