复发性泪囊炎经鼻内镜泪囊鼻腔造孔术

目的 评价复发性泪囊炎经鼻内镜泪囊鼻腔造孔术的疗效。方法 对38例(44眼)病人行鼻内镜下吻合口瘢痕组织切除，造孔留置支撑物2～3个月。结果 经术后随访6个月～36个月，治愈40眼，占91％：好转2眼，无效2眼，各占4．5％。结论 该手术方式效果确切，易操作，创伤小，不影响面部美观，是治疗复发性泪囊炎的一种理想方法。     

经鼻内窥镜鼻内泪囊鼻腔造孔术治疗复发性泪囊炎

目的探讨鼻内窥镜下鼻内泪囊鼻腔造孔术治疗复发性泪囊炎的方法和临床疗效.方法回顾分析鼻内泪囊鼻腔造孔术治疗复发性泪囊炎18例、22眼的临床资料,随访3～12个月.结果18例、22眼中治愈20眼,占90.9%,好转2眼,占9.1%,未发生手术并发症.结论经鼻内窥镜行鼻内泪囊鼻腔造孔术治疗复发性泪囊炎有效,具有操作简单、快捷、微创等优点,疗效满意,并可同期处理影响预后的鼻腔疾病.     

鼻内镜下银夹固定泪囊造孔治疗慢性泪囊炎

目的探讨经鼻内镜下利用银夹固定泪囊造孔治疗慢性泪囊炎。方法对39例(42眼)慢性泪囊炎病人经鼻内镜行泪囊鼻腔造口,用银夹把造口处泪囊黏膜和鼻腔黏骨膜固定吻合,无需置管让其形成瘘口。所有病例随访3个月以上,对其疗效观察分析。结果手术治愈36眼(85.7%),好转3眼(7.1%),无效3眼(7.1%)。无效3眼为泪囊狭窄所致,改留置腰麻管2个月后泪道部分通畅。结论经鼻内镜银夹固定泪囊造孔治疗慢性泪囊炎,操作简便、方便,疗程短,有良好的治疗效果,是较理想的手术方式。     

改良鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎

目的:探讨改良鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的手术方法及其疗效。方法:通过对造孔、泪囊黏膜瓣的切开及固定方式等的改良处理,在鼻内镜下完成泪囊鼻腔造孔术治疗慢性泪囊炎22例(23眼)。结果:术后随访6～10个月,平均8个月。22例(23眼)中,21例(22眼)治愈,症状完全消失,泪道冲洗畅通,内镜检查造孔通畅;1例(1眼)症状改善不明显。总有效率95.7%(22/23)。所有患者未出现严重并发症。结论:改良鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎明显提高了手术成功率,值得临床推广。     

鼻内镜下鼻腔泪囊造孔术治疗复发性泪囊炎

慢性泪囊炎经鼻外径路泪囊鼻腔吻合术后复发,常需再次手术治疗。近年来,随着鼻内镜技术的发展,鼻内镜下鼻腔泪囊造孔术治疗复发性泪囊炎已取得较好的疗效。本文回顾性分析了22例（26侧）复发性泪囊炎经鼻内镜鼻腔泪囊造孔术治疗的临床资料,现报告如下。     

鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎

目的探讨鼻内镜下鼻腔泪囊造孔术治疗慢性泪囊炎的手术方式及临床疗效。方法32例(35眼)采用德国Storz公司0°鼻内镜及手术器械行泪囊鼻腔造孔术,下泪小点植入硬脑膜外麻醉用硅胶导管,留置于中鼻道3~6个月。结果随访6个月至2年,随访30例(32眼),27眼泪道通畅,炎症消退;3眼术后泪囊造口处粘连闭锁,经鼻内镜下开放泪囊造口,泪道恢复通畅。2眼泪道阻塞,检查泪囊造孔处通畅,行泪道冲洗多次,1眼泪道恢复通畅,1眼仍有阻塞,经再次置管处理,恢复正常。结论该术式具有创伤小,面部不遗留瘢痕,操作简便等特点。术后随访是提高手术成功率的重要措施。     

鼻内镜下泪囊鼻腔吻合术42例手术体会

目的 总结鼻内镜下泪囊鼻腔吻合术治疗慢性泪囊炎的临床体会.方法 回顾性分析2009年9月～2013年4月42例（45眼）慢性泪囊炎病人均在鼻内镜下行泪囊鼻腔吻合术,随访6个月至2年.结果 治愈39眼,好转4眼,无效2眼,有效率达95.0％.结论 鼻内镜下泪囊鼻腔吻合术具有操作简单、创伤小、并发症少和美观无瘢痕及治愈率高的优点。     

鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎16例

目的报告鼻内镜下行鼻内鼻腔泪囊造孔术的手术方法及疗效。方法由鼻内径路鼻内镜下施行鼻腔泪囊造孔术,治疗慢性泪囊炎共16例(16眼)。结果治愈12眼,好转2眼,无效2眼,有效率87.5%(14/16)。结论本术式操作简便,损伤小,恢复快,无面部瘢痕,疗效显著。     

鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎

慢性泪囊炎最初是由眼科医师经鼻外径路手术治疗.自鼻内镜手术开展以来,经鼻内镜手术治疗慢性泪囊炎已成为鼻眼相关外科重要内容之一.我科自2005年以来在鼻内镜下对泪囊鼻腔造孔术治疗慢性泪囊炎稍做改进,取得了良好的疗效,现报道如下.     

鼻内镜下泪囊鼻腔造孔术

目的总结鼻内镜下泪囊鼻腔造孔术并探讨术后鼻泪管再通现象及其原因。方法36例(39眼)慢性泪囊炎患者,男7例(7眼),女29例(32眼),年龄23￣71岁,平均39.6岁,病程半年￣12年,均在局麻、鼻内镜下行泪囊鼻腔造孔术,随访亦在鼻内镜下进行,以黏膜表面麻醉为主。结果术后8￣10周术腔逐渐上皮化,35眼泪道冲洗通畅,溢泪及溢脓症状均消失;2眼冲洗通而不畅,需加压,有冲洗液溢出;2眼泪道冲洗不通,仍有溢泪及溢脓症状。总有效率94.5%(37/39)。鼻内镜下观察,冲洗通畅者造瘘口有液体流出。随访6个月部分病人(4眼)下鼻道原鼻泪管开口处冲洗时亦有液体流出。结论慢性泪囊炎病人在行鼻内镜下泪囊鼻腔造孔术后效果好,且部分病人鼻泪管可再通。     

鼻内镜下泪囊鼻腔造孔术造孔的处理

目的:探讨更好地处理鼻内镜下泪囊鼻腔造孔术造孔的方法。方法:102例(109眼)慢性泪囊炎患者于鼻内镜下行泪囊鼻腔造孔术,术中用银夹固定造孔,术后给予综合治疗,并随访3～73个月。结果:治愈99眼(91.0%),好转5眼(4.5%),有效率95.5%。结论:泪囊鼻腔造孔术用银夹固定造孔,术后辅以综合治疗,可有效防止造孔的狭窄、闭锁。     

Otologic T-tube in endonasal dacryocystorhinostomy: a new approach

CONCLUSION: Otologic T-tubes had a success rate of 73% if implanted during endoscopic dacryocystorhinostomy (DCR). We suggest that they can be used successfully in endoscopic DCR, and are promising as an alternative to silicone stent intubations. OBJECTIVE: To evaluate the efficacy of endoscopic DCR using otologic T-tube. MATERIALS AND METHODS: Twenty patients (22 eyes) with nasolacrimal duct obstruction underwent endoscopic DCR. After creating an aperture in the medial wall of the lacrimal sac, the otologic T-tube (1.15 mm diameter, Invotec, Jacksonville, FL, USA) was inserted into the sac transnasally. The T-tube was left in the lacrimal sac for between 3 and 6 months. The patients were followed up for between 6 and 24 months (mean 12.4 months). The improvement in patients' epiphora complaint was grouped as very good, good, or no change. RESULTS: Eleven eyes (50%) proved to be 'very good', whereas five eyes (23%) were good, and six eyes (27%) had no change. Of six eyes that were reported to have no change after the operation, three experienced spontaneous tube loss in the early period, one eye was a recurrent case, and the other two were primary cases.     

Otologic T-tube in endonasal dacryocystorhinostomy: a new approach

Conclusion. Otologic T-tubes had a success rate of 73% if implanted during endoscopic dacryocystorhinostomy (DCR). We suggest that they can be used successfully in endoscopic DCR, and are promising as an alternative to silicone stent intubations. Objective. To evaluate the efficacy of endoscopic DCR using otologic T-tube. Materials and methods. Twenty patients (22 eyes) with nasolacrimal duct obstruction underwent endoscopic DCR. After creating an aperture in the medial wall of the lacrimal sac, the otologic T-tube (1.15 mm diameter, Invotec, Jacksonville, FL, USA) was inserted into the sac transnasally. The T-tube was left in the lacrimal sac for between 3 and 6 months. The patients were followed up for between 6 and 24 months (mean 12.4 months). The improvement in patients’ epiphora complaint was grouped as very good, good, or no change. Results. Eleven eyes (50%) proved to be ‘very good’, whereas five eyes (23%) were good, and six eyes (27%) had no change. Of six eyes that were reported to have no change after the operation, three experienced spontaneous tube loss in the early period, one eye was a recurrent case, and the other two were primary cases.     

改良经鼻内镜下泪囊鼻腔造孔术

目的报道经鼻内镜下泪囊鼻腔造孔术的改良及其疗效,就改良手术方法和目的进行探讨。方法采用改良经鼻内镜下泪囊鼻腔造孔术治疗的慢性泪囊炎患者31例(35眼)。男性4例,女性27例。年龄9～70岁,平均31岁。术前行泪囊碘油造影。随访6～20个月。结果31例(35眼)慢性泪囊炎,双眼患者4例;2例(2眼)为鼻内镜手术损伤致泪囊炎。前期泪囊鼻腔激光手术病史4例(5眼),鼻外径路手术2例(2眼)。28例(91.4%,32/35眼)治愈,症状消失,鼻腔造孔通畅。1例术后1周取出膨胀海绵时发生鼻腔黏膜瓣位置移位;2例术后6个月造孔瘢痕闭锁,其中1例再手术后治愈。总有效率97.1%(34/35眼)。结论保留鼻腔黏膜瓣并以此修复裸露骨质,可最大程度避免和减少骨质和瘢痕增生,有助于提高和取得满意的临床泪囊鼻腔造孔治疗效果。     

Prolene®: a novel,cheap, and effective material in dacryocystorhinostomy

Conclusion. Prolene® is cheap, effective, and readily available in almost all operating theaters. It might be used successfully in endoscopic dacryocystorhinostomy and is promising as an alternative to silicone stent intubations, especially in settings with limited resources. Objective. To evaluate the clinical efficacy and results of stenting with polypropylene (Prolene®; Ethicon, Inc.) suture material instead of silicone tube in endoscopic dacryocystorhinostomy. Patients and methods. Forty-two endoscopic dacryocystorhinostomy operations were performed in 36 patients (11 men and 25 women; mean age 34.7±9.5 years, range 16–60 years) between 2007 and 2008. After creating an aperture in the medial wall of the lacrimal sac, 2/0 Prolene was inserted through the canaliculi into the sac. The Prolene was left in the lacrimal sac for 3 months. The patients were followed up for between 6 and 18 months (mean 8.1±3.6 months). The improvement in the complaint of epiphora was grouped as very good, good, or no change. Results. The improvement in 34 eyes (81%) was reported as very good, whereas improvement was noted as good in 5 eyes (11.9%), and there was no change in 3 eyes (7.1%). We observed granulation tissue formation around the Prolene in two patients.     

鼻内镜鼻腔泪囊造口术治疗复发性泪囊炎

目的探讨鼻腔泪囊造口术后复发患者,再次手术中的常见问题及其防治措施。方法2003年7月至2008年7月我科共收治鼻腔泪囊造口术后复发患者44例（44眼）,探讨再次手术中常见问题及防治措施,所有患者术后随访6个月至1年以上,观察疗效。结果术中常见的问题依次为出血、泪囊定位、骨孔大小及位置、造口的大小以及鼻及鼻窦疾病等。术后44例患者,有41例溢泪等症状完全消失,手术成功率达93.18%。结论专业的设备、熟练的手术操作、熟悉泪囊的解剖和适当的处理,有助于我们正确处理术中常见的各种问题,提高手术的成功率。     

改良鼻内窥镜下泪囊鼻腔造孔术的临床观察

［摘要］目的：探讨改良鼻内窥镜下泪囊鼻腔造孔术的方法及疗效。方法：常规于鼻内窥镜下制作骨孔后，制作较大的泪囊黏膜瓣，并采用自制的前针孔缝合针将泪囊、鼻腔黏膜瓣重叠缝合固定于内眦部皮肤的深面。结果：随访3～21个月，42例、56眼中，治愈38例、51眼，好转3例、4眼，无效1例、1眼。治愈率为91.1%，总有效率为98.2%。结论：鼻内窥镜下泪囊鼻腔吻合术可有效地防止吻合口远期瘢痕挛缩闭锁，具有较好的疗效。     

鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎的手术探讨

目的 探讨经鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎的手术方式、技巧及临床疗效。方法 采用鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎28例(30眼),术后在鼻内镜下行常规泪道冲洗及鼻腔清理换药。结果 所有病例随访6个月,治愈率93.33%,总有效率100% 。结论 经鼻内镜下泪囊鼻腔吻合术是治疗慢性泪囊炎的理想方法,具有创伤性小、治愈率高、不影响美容的特点。     

鼻内镜下泪囊鼻腔吻合术治疗慢性泪囊炎

目的 探讨经鼻内镜泪囊鼻腔吻合术的方法与临床效果。方法 1991年11月-2006年3月采用鼻内镜下泪囊鼻腔吻合术治疗慢性泪囊炎患者144例（155眼）。回顾分析其临床资料，总结手术方法，观察临床疗效。结果 144例患者（155眼）术后随访1年，治愈率为87．7％（136／155），显效率4．5％（7／155），有效率1．9％（3／155），无效5．8％（9／155），总有效率94．2％（146／155）。结论 严格掌握手术适应证、熟悉有关解剖、牢记手术操作要点，鼻内镜下泪囊鼻腔吻合术是治疗慢性泪囊炎的一种有效方法，同时对鼻-鼻窦疾病的治疗及术后随访处理是提高鼻内镜下泪囊鼻腔吻合术疗效的有效手段。