Results of Endoscopic Endonasal Dacryocystorhinostomy: The Necessity of Teamwork and Appropriate Patient Selection

To evaluate the clinical results of endoscopic endonasal surgical dacryocystorhinostomy (EES-DCR) as team work by an ophthalmologist and an ear-nose-throat (ENT) surgeon and the appropriate selection of the patients this study performed.All candidates for DCR underwent computed tomography (CT) scan of the paranasal sinuses (PNS). Patients who did not want a scar on the medial canthus skin or who did not have intranasal problems received EES-DCR, which was performed as team work by an ophthalmologist and an ENT surgeon. Surgical success was the resolution of epiphora (i.e., functional success) and free passage of the fluid on irrigation (i.e., anatomical success) by six months after surgery.One hundred twenty-eight patients underwent EES-DCR. Six months following the operation, six patients underwent surgical failure (three cases of anatomical failure and three cases of functional failure); the success rate was therefore 95.3%. The most common intranasal problems that led to EES-DCR were sinusitis, septal deviation, close proximity of the agger nasi to the lacrimal bone, and concha bullosa; moreover, 15.5% of patients selected EES-DCR for cosmetic reasons. Cooperation between ophthalmologists and ENT surgeons in the preoperative assessment of patients with epiphora before EES-DCR increases its success rate, and it may replace external DCR in some patients

Results of Endoscopic Endonasal Dacryocystorhinostomy: The Necessity of Teamwork and Appropriate Patient Selection

To evaluate the clinical results of endoscopic endonasal surgical dacryocystorhinostomy (EES-DCR) as team work by an ophthalmologist and an ear-nose-throat (ENT) surgeon and the appropriate selection of the patients this study performed.All candidates for DCR underwent computed tomography (CT) scan of the paranasal sinuses (PNS). Patients who did not want a scar on the medial canthus skin or who did not have intranasal problems received EES-DCR, which was performed as team work by an ophthalmologist and an ENT surgeon. Surgical success was the resolution of epiphora (i.e., functional success) and free passage of the fluid on irrigation (i.e., anatomical success) by six months after surgery.One hundred twenty-eight patients underwent EES-DCR. Six months following the operation, six patients underwent surgical failure (three cases of anatomical failure and three cases of functional failure); the success rate was therefore 95.3%. The most common intranasal problems that led to EES-DCR were sinusitis, septal deviation, close proximity of the agger nasi to the lacrimal bone, and concha bullosa; moreover, 15.5% of patients selected EES-DCR for cosmetic reasons. Cooperation between ophthalmologists and ENT surgeons in the preoperative assessment of patients with epiphora before EES-DCR increases its success rate, and it may replace external DCR in some patients

Molecular signatures of anthroponotic cutaneous leishmaniasis in the lesions of patients infected with Leishmania tropica

Anthroponotic cutaneous leishmaniasis (CL) caused by Leishmania tropica (L. tropica) represents a public health challenge in several resource poor settings. We herein employed a systems analysis approach to study molecular signatures of CL caused by L. tropica in the skin lesions of ulcerative CL (UCL) and non-ulcerative CL (NUCL) patients. Results from RNA-seq analysis determined shared and unique functional transcriptional pathways in the lesions of the UCL and NUCL patients. Several transcriptional pathways involved in inflammatory response were positively enriched in the CL lesions. A multiplexed inflammatory protein analysis showed differential profiles of inflammatory cytokines and chemokines in the UCL and NUCL lesions. Transcriptional pathways for Fcγ receptor dependent phagocytosis were among shared enriched pathways. Using L. tropica specific antibody (Ab)-mediated phagocytosis assays, we could substantiate Ab-dependent cellular phagocytosis (ADCP) and Ab-dependent neutrophil phagocytosis (ADNP) activities in the lesions of the UCL and NUCL patients, which correlated with L. tropica specific IgG Abs. Interestingly, a negative correlation was observed between parasite load and L. tropica specific IgG/ADCP/ADNP in the skin lesions of CL patients. These results enhance our understanding of human skin response to CL caused by L. tropica.ISSN:2045-232