S.A. KARPISHENKO, N.Yu. BELDOVSKAYA, S.V. BARANSKAYA, A.A. KARPOV

Pavlov First Saint Petersburg State Medical University, 6-8 Leo Tolstoy Str., Saint Petersburg, Russian Federation, 197022

Karpishchenko S.A. — Doc. Med. Sc., Professor, Head of the ENT Department, tel. (812) 338-70-19, e-mail: karpischenkos@mail.ru

Beldovskaya N.Yu. — Cand. Med. Sc., Associate Professor of the Ophthalmology Department, tel. (812) 338-71-73, e-mail: beldovskay@mail.ru

Baranskaya S.V. — post-graduate student of the ENT Department, tel. (812) 338-71-76, e-mail: sv-v-b@yandex.ru

Karpov A.A. — resident of the ENT Department, tel. (812) 338-71-76, e-mail: artemiykarpov@mail.ru

Adjuvant radioactive iodine therapy is a modern treatment of differentiated thyroid cancer but the nasolacrimal duct obstruction is one of the possible complications.

Objective: to estimate the efficiency of endoscopic endonasal dacryocystorhinostomy in the treatment of secondary acquired nasolacrimal duct obstruction after adjuvant radioactive iodine therapy.

Materials and methods. We analyzed clinical data of seven patients with secondary acquired nasolacrimal duct obstruction after radioactive iodine therapy. The patients underwent endoscopic endonasal dacryocystorhinostomy in the ENT Department of Pavlov First Saint Petersburg State Medical University between January 2014 and January 2018.

Results. The average interval between the last dose of radioactive iodine and stating the diagnosis of nasolacrimal duct stenosis was 11.5 months, ranging from 4 to 20 months. 4 patients had bilateral obstruction. The age of patients ranged from 34 to 73 years. The mean cumulative dose of radioiodine was 497 mCi (range 250-960 mCi). All patients underwent primary or revision endoscopic endonasal dacryocystorhinostomy. Complete or partial dacryostenosis resolution after surgery occurred in all cases. Mean follow-up was 5 months (range 3-24 months).

Conclusion. Secondary acquired nasolacrimal duct obstruction is a rare complication of radioactive iodine therapy in patients with differentiated thyroid cancer and depends on the cumulative dose received. Our experience showed the high effectiveness of endoscopic endonasal dacryocystorhinostomy in the treatment of patients with secondary acquired nasolacrimal duct obstruction after radioactive iodine therapy.

Key words: nasolacrimal duct obstruction, radioiodine therapy, endoscopic endonasal dacryocystorhinostomy, thyroid cancer.

(For citation: Karpishchenko S.A., Beldovskaya N.Yu., Baranskaya S.V., Karpov A.A. Outcomes of endoscopic endonasal dacryocystorhinostomy in the treatment of secondary acquired nasolacrimal duct obstruction after radioiodine therapy. Practical Medicine. 2018)

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