Radiofrequency-Assisted Endofistulectomy: Treating Coexisting Lacrimal Fistulae During Endoscopic Dacryocystorhinostomy
Bothra, Nandini M.D.; Ali, Mohammad Javed M.D., Ph.DRead More
To assess the efficacy of radiofrequency-assisted endofistulectomy in patients with lacrimal fistulae communicating with the lacrimal sac.
Retrospective interventional case series of patients undergoing endoscopic dacryocystorhinostomy with endofistulectomy from June 2016 to January 2020 were studied. The indications of endoscopic dacryocystorhinostomy were associated refractory complex congenital nasolacrimal duct obstructions and primary-acquired nasolacrimal duct obstruction. The communication of the fistulae with the lacrimal sac was ascertained. Specific surgical parameters and technique were used, and the variables assessed include patient demographics, clinical presentation, indications, surgical technique, recurrences, and outcomes.
Six eyes of 6 patients with mean age of 23.33 years underwent radiofrequency-assisted endofistulectomy. The surgical technique was found to be minimally invasive, easy to perform with multiple advantages like absence of a skin incision, targeting of the complete extent of the fistula, and complete closure of the external and internal openings of the fistulae. At 4 weeks, dacryocystorhinostomy ostium was well mucosalized and patent with a dynamic common canalicular opening. The fistula site had healed well with no epiphora or discharge or residual scarring.
Conclusion: Radiofrequency-assisted endofistulectomy is a minimally invasive and viable alternative to incisional fistulectomy in select group of patients of congenital or acquired fistulae which communicate with the lacrimal sac.