Name of the Procedure:

Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial
Common names: Partial dacryoadenectomy, Partial excision of the lacrimal gland

Summary

A partial dacryoadenectomy involves the surgical removal of a portion of the lacrimal gland, which is responsible for producing tears. This procedure is distinct in that it addresses conditions other than tumors, focusing on issues such as chronic inflammation or other benign conditions.

Purpose

This procedure addresses non-tumorous conditions affecting the lacrimal gland, such as chronic dacryoadenitis (inflammation of the lacrimal gland) or other benign lesions. The goal is to alleviate symptoms like persistent eye discomfort, swelling, or excessive tearing that haven’t responded to other treatments.

Indications

• Chronic dacryoadenitis not responding to medical therapy
• Benign tumors or lesions in the lacrimal gland
• Persistent eye discomfort or irritation due to lacrimal gland issues
• Excessive tearing or swelling unresponsive to other treatments

Preparation

• Pre-procedure fasting typically required (duration as advised by the physician)
• Discontinuation of certain medications (e.g., blood thinners) as advised
• Pre-operative diagnostic tests such as imaging studies (e.g., CT or MRI scans) to evaluate the gland
• Pre-anesthetic assessment and clearance

Procedure Description

1. Anesthesia: Administered general anesthesia or local anesthesia with sedation.
2. Incision: Small incision made near the upper eyelid.
3. Access: Gaining access to the lacrimal gland through the incision.
4. Excision: Carefully removing the portion of the lacrimal gland causing issues, preserving as much of the gland as possible to maintain tear production.
5. Closure: Stitches to close the incision and application of a sterile dressing.

Specialized surgical tools and techniques are employed to ensure precision and minimize damage to surrounding tissues.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

Performed in a hospital setting, typically in an outpatient surgical center or specialized ophthalmic surgery unit.

Personnel

• Ophthalmic surgeon
• Anesthesiologist
• Surgical nurses and support staff

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding tissues or structures
• Altered tear production, leading to dry eye or excessive tearing
• Scarring or changes in eyelid function

Benefits

• Relief from chronic symptoms such as eye discomfort, swelling, and excessive tearing
• Improved quality of life due to reduction or elimination of symptoms Benefits often realized within a few weeks following the procedure.

Recovery

• Post-procedure care includes cold compresses to reduce swelling and pain
• Use of prescribed medications such as antibiotics to prevent infection
• Avoiding strenuous activities for a specified period
• Follow-up appointments for monitoring healing and removal of stitches Expected recovery time is around 1 to 2 weeks, though it can vary.

Alternatives

• Conservative management with medications (e.g., anti-inflammatory drugs)
• Needle aspiration of fluid in some instances
• Radiation therapy or chemotherapy if applicable
• Observation and regular monitoring

Each alternative has its pros and cons, depending on the specific condition and patient health.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be mild to moderate discomfort, managed with prescribed pain relievers. Most patients experience swelling and bruising around the eyelid, which typically subsides within a week or two. Regular follow-up ensures optimal recovery and management of any complications.