Endoscopic dacryocystorhinostomy among the old and oldest-old populations - A case control study |
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| Authors: | Idit Tessler Meir Warman Itai Amos Doron Halperin Yosef Bavnik Asher Milstein Yochai Shoshani Hana Leiba Oded Cohen |
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| Affiliation: | 1. Hadassah Medical School, Hebrew University, Jerusalem, Israel;2. Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel;3. Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel;1. Department of Otolaryngology – Head and Neck Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji Agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, Kyoto, Japan;2. Department of Otolaryngology, Akashi City Hospital, Akashi, Hyogo, Japan;1. Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Toon, Japan;2. Department of Otolaryngology, Head and Neck Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan;3. Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Toon, Japan;4. Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan;1. Neuro-otology, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia;2. Pediatric ENT, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia;3. Division of Otolaryngology, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Carrera 7 40-62, Desk 712, Bogotá, Colombia;4. Pontificia Universidad Javeriana, Bogotá, Colombia;1. Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan;2. Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan;3. Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan;4. Division of Pulmonary, Critical Care, and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan;5. College of Medicine, Chang Gung University, Taoyuan, Taiwan;1. Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Alexandria University Main Hospital, El-Khartoum Square, Azarita Medical Campus, Alexandria 21542, Egypt;2. Department of Otorhinolaryngology-Head & Neck Surgery, Royal Private Hospital, Alexandria, Egypt |
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| Abstract: | ObjectiveDespite increased risks of nasolacrimal duct obstruction (NLDO) with age, and the continuous growth of the old population proportion, data on endoscopic dacryocystorhinostomy (eDCR) among the old is lacking. This study aims to evaluate long-term eDCR efficacy and safety in the old and oldest-old population.MethodsA retrospective case-control study of patients aged 80 ≤ (oldest-old) and 65–79 (old) compared with younger controls who underwent eDCR, between 2002 and 2017. Pre-, intra- and postoperative factors were collected using an integrated hospital-community system. Success rates were analyzed and measured at the first visit following surgery (immediate success), and after five years. Demographics, comorbidities, complications rates, and outcomes were compared between the groups.ResultsThe study groups included 52 oldest-old patients (mean age 83.4 ± 3.6), 127 old patients (72.3 ± 4.14) and 142 control patients (57.8 ± 18.0). The immediate and success rates were 94.2%, 93.7% and 90.8% and five-year success rates were 80.0%, 76.6% and 80% among oldest-old, old and controls, respectively. No significant differences in success rates were found, even despite higher comorbidity rates among the study's group (96 and 92.8% vs. 63.2%, among oldest-old, old and controls respectively, p <0.001). Intra- and postoperative complications rates were low in all groups.ConclusionsAmong older population, including oldest-old and old, eDCR safety and long-term outcomes are comparable with younger patients, suggesting that eDCR should be offered to NLDO patients, regardless of age. |
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