Acute Dacryocystitis with Empyema of the Lacrimal Sac: Is Immediate Endoscopic Dacryocystorhinostomy Justified?
Bibliographic record
Abstract
Objectives: To evaluate the efficacy of endoscopic dacryocystorhinostomy (endoDCR) in the treatment of acute dacryocystitis with lacrimal sac empyema (ADLSE). Methods: Design: Single center cohort study. Setting: Academic tertiary center. Patients: Twenty‐one consecutive patients who underwent endoDCR for ADLSE between August 2005 and December 2012 were included. Main outcome measures: The success of the procedure was defined as complete complaint relief and DCR patency. Time from referral to surgery, post‐operative complications, and revision surgery data were also reported. Results: The present cohort of patients included 3 males (14.3%) and 18 females (85.7%) (median age: 66 years). Median time between referral and surgery was 0 days (mean: 0.86 days). Median follow‐up was 12 months. All patients showed immediate relief from symptoms, with no recurrences of ADSLE. Complete success was achieved in 20 of 21 (95.2%) cases; the only failure was recorded in a patient who had previously undergone radio‐iodine treatment. In this case also revision endoDCR was not successful. The only perioperative complication was an epistaxis requiring revision surgery under general anesthesia. The definitive success rate was 95.2% after primary and revision surgery. Conclusions: EndoDCR enables rapid solution of ADSLE with a very high success rate. Immediate surgery minimizes the risk of skin fistulization and/or orbital complications; DCR shrinkage and lacrimal obstruction are unlikely since the procedure is performed on an enlarged sac. In comparison with external DCR, the absence of skin incision in an inflamed and infected field is the main advantage.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".