共查询到19条相似文献,搜索用时 154 毫秒
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目的 探讨鼻内镜下经鼻腔手术治疗鼻泪管阻塞的适应证、手术方法和技巧.方法 回顾分析2001~2005年开展的鼻泪管阻塞患者经鼻内镜下行泪骨、上颌骨额突造口,鼻腔泪囊开窗法或吻合扩张法手术治疗45例(47眼)患者的临床资料.结果 术后随访6~ 12个月,治愈41眼,占87.23%;好转1眼,占2.13%;无效5眼,占10.64%.结论 该手术适应广泛:慢性或复发性泪囊炎、泪囊黏液囊肿、外伤性鼻泪管阻塞等,只要有可探及并可实施造口操作的泪囊结构均适合此手术.以鼻腔泪囊开窗法为佳.对于小泪囊、泪囊粘连或分隔形成等,可行引入扩张管或扩张纱条即吻合扩张法手术.该手术方法明显好于于鼻外内眦切开法. 相似文献
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60例慢性泪囊炎患者随机分为内镜组和对照组各30例。内镜组给予鼻内镜下泪囊鼻腔造孔术。对照组给予鼻外泪囊鼻腔吻合术。结果内镜组总有效率93.33%,对照组总有效率90.00%,两组比较差异无统计学意义(P>0.05)。内镜组患者术后满意度评分为83.48±11.36分,对照组患者术后满意度评分为76.72±10.65分,两组比较差异具有统计学意义(P<0.05)。鼻外泪囊鼻腔吻合术和鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的疗效相当,但鼻内镜下泪囊鼻腔造孔术具有面部不留瘢痕,微创,美容,恢复快,术后患者满意度高。 相似文献
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目的 探讨经鼻内镜下行泪囊鼻腔造孔术治疗慢性泪囊炎的临床价值。方法 对 19例慢性泪囊患者进行经鼻内镜下行泪囊鼻腔造孔术 ,16例术后随访 6个月以上 ,3例术后 2个月失访。结果 本组 19例 (2 1眼 )慢性泪囊患者 ,19眼治愈 ,2眼好转 ,未见严重并发症。结论 经鼻内镜下行泪囊鼻腔造孔术具有术野清晰 ,操作简单 ,无面部切口疤痕 ,损伤小等优点 ,值得临床推广应用。 相似文献
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目的探讨经鼻内镜鼻腔泪囊造孔术治疗慢性泪囊炎的护理方法.方法对45例慢性泪囊炎患者应用鼻内镜行鼻腔泪囊造孔术,术前进行有效的心理护理,鼻腔冲洗指导,术后加强术腔管理,预防并发症.结果本组45例患者术前心理状态稳定,手术效果满意,术后未发生严重并发症.结论经鼻内镜鼻腔泪囊造孔术是治疗慢性泪囊炎的有效方法,加强术前术后心理护理,及术后术侧鼻腔的管理,进行有针对性的健康指导,加强术后随访,是手术成功的重要保证. 相似文献
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《Minimally invasive therapy & allied technologies》2013,22(6):505-510
SummaryEndoscopic dacryocystorhinostomy (DCR) was successfully performed in 40 patients, with four patients having bilateral surgery. Follow-up data were obtained on 43/44 eyes using clinical notes and a patient questionnaire. Range of follow up was 1–46 months, with an average of 18 months (in nine patients follow up was at least 3 years). Epiphora was successfully relieved in 86% of patients and there was no evidence of a recurrence of nasolacrimal obstruction in the long term. Endoscopic DCR is a relatively quick and simple procedure with low morbidity, and as such is suitable for day case surgery. Satisfactory long-term results make endoscopic DCR an alternative to external DCR as primary surgical treatment for nasolacrimal duct obstruction. In cases of failed external DCR, or when epiphora is iatrogenic following surgery to the lateral nasal wall, a transnasal endoscopic approach is probably the treatment of choice. 相似文献
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背景:国内外对严重泪道阻塞的治疗,还没有理想的方法.如何改进手术方式,选择合适的移植材料,提高治疗效果,容易让患者接受是泪道阻塞诊治研究工作者的课题.目的:评估经鼻内窥镜泪囊窝造口自体大隐静脉或居黏膜移植泪道再造的有效性和安全性.设计、时间及地点:对比观察,于2005-04/2007-06在武装警察部队总医院完成.对象:选择武装警察部队总医院收治的上、下泪小管严重阻塞合并泪囊缺失或萎缩患者18例伯眼.方法:根据移植材料分为2组,大隐静脉组9例,口唇黏膜组9例.大隐静脉组采用自体大隐静脉移植,口唇黏膜组采用自体口唇黏膜移植.对2组患者移植后泪道通畅情况、泪溢症状改善的程度和并发症等做统计分析.主要观察指标:移植后带管期间泪溢症状改善情况,拔管后泪道探查冲洗情况,拔管后第12周泪道放射性核素~(99)Tc~m(TcO_4~-)显影检查核素入鼻时间,判定治疗效果.结果:两组患者移植后带管3个月期间,泪溢症状即可得到不同程度的改善.拔管后第12周,泪道放射性核素88Tcm显影检查,核素入鼻时间分别为(8.58±4.3)min和(9.16±5.8)min,两组差异无显著性意义(P>0.05).大隐静脉组和口唇黏膜组的治愈病例分别是6例和5例,好转病例均为2例,无效病例数分别为1例和2例.结论:经鼻内窥镜泪囊窝造口自体大隐静脉或唇黏膜移植泪道再造治疗严重泪道阻塞安全、有效,自体大隐静脉和唇黏膜作为移植材料各有优缺点. 相似文献
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Congenital nasolacrimal duct obstruction is a classic condition that has been well investigated and is readily identified. The suggested sequence of treatment includes massage, irrigation, probing, insertion of a silicone stent and, finally, dacryocystorhinostomy. Because of the relatively frequent occurrence of duct obstruction in normal infants, family physicians need to be familiar with its diagnosis and treatment. If problems still exist after an adequate trial of conservative treatment, referral before six months of age is suggested. 相似文献
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背景:人工鼻泪管植入治疗泪道阻塞性疾病不会改变泪道的解剖结构,是一种简单有效的治疗方法。目的:评价人工鼻泪管植入治疗泪道阻塞性疾病的有效性及安全性。方法:选择2008/2009逆行性人工鼻泪管植入治疗泪道阻塞患者87例,共94眼,年龄26~71岁,平均56岁。其中鼻泪管阻塞患者31例,慢性泪囊炎患者56例。随访时间为18个月。结果与结论:人工鼻泪管植入后第2天92眼溢泪症状完全缓解,成功率为98%(92/94)。随访中,85眼人工鼻泪管保持通畅,8眼发生阻塞,1眼发生人工鼻泪管移位,植入有效率为90%(85/94)。植入后有7例患者出现疼痛,2例出现眼睑水肿,所有患者均有少量鼻出血,经对症处理后均缓解。结果可见人工鼻泪管植入是治疗泪道阻塞性疾病简单有效安全的方法。 相似文献
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《Minimally invasive therapy & allied technologies》2013,22(5):266-270
Abstract Aims: To study the efficacy of a new technique of single self-linking silicone stent exclusively in pediatric external dacryocystorhinostomy (DCR) and to report the new use and advantages of endoscopic guidance for the same. Material and methods: Prospective interventional case series, including 11 eyes of ten patients with nasolacrimal duct obstruction. Data collected included demographic data, clinical presentation, laterality, status of lids and puncta, syringing findings, probing interpretations, types and duration of intubation. Consecutive pediatric patients with post-saccal obstruction who underwent an external dacryocystorhinostomy were included. Exclusion criteria included patients who had undergone a DCR in the past by any route via external, endonasal or transcanalicular. Primary outcome measures were stent retention and ease of stent removal. Secondary outcome measures were anatomic patency of the passage and resolution of symptoms. Results: There were three male and seven female patients. Mean age was 9.4 years (range 6–15). A total of 11 procedures were carried out. Following placement of self-linked stents, the removal was done at a mean duration of 13.2 weeks (range:12–16 weeks). None of the patients had a stent prolapse during this period. All stents were removed in the outpatient without the use of general anesthesia with minimal endoscopic guidance. A minimum follow-up of three months following removal was considered for final analysis. Follow-up ranged from three months to six months after tube removal. The anatomical and functional success rate was 91%. There was one anatomical failure three months following tube removal and the remaining patients were free of symptoms at the last follow-up. Conclusions: Self-linking stents are a useful modality in pediatric patients not only to prevent stent prolapse but also to allow easy removal with minimum discomfort. Endoscopic guidance is a useful addition to this technique. 相似文献
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目的 观察慢性泪囊炎行泪囊鼻腔吻合术术后复发经鼻内窥镜下手术治疗的疗效,探讨泪囊鼻腔吻合术术后复发的有效治疗方法.方法 对13例(14眼)慢性泪囊炎行泪囊鼻腔吻合术术后复发的患者应用经鼻内窥镜下再次手术治疗,术后随访6个月~ 2年,复查时行泪道冲洗及鼻内镜检查.结果 9例10眼治愈,占71.4%;2例2眼有效,占14.3%;2例2眼无效.总有效率85.7%.结论 经鼻内窥镜下手术治疗泪囊鼻腔吻合术术后复发,手术简便,成功率高,不再次造成面部瘢痕,是一种有效的手术方法. 相似文献
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Zi-Gang Che Ting Ni Zhen-Chang Wang De-Wang Wang 《World Journal of Clinical Cases》2021,9(8):1940-1945
BACKGROUNDNasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint, and it may derive from amyloidosis in rare cases. There are a few reports about localized amyloidosis, and amyloidosis with involvement and obstruction of the nasolacrimal duct is exceedingly rare. CASE SUMMARYA 54-year-old male presented with a 2-year history of a lump overlying the left lacrimal sac that had grown rapidly for nearly half a year. Physical examination touched a firm lump in the left lacrimal sac. Nasal endoscopy discovered lesions in appearance of sediments with easy bleeding at the entry of the nasolacrimal duct of the left inferior nasal meatus. Computerized tomography scan revealed speckle high density in the left lacrimal sac and the dilated nasolacrimal duct. During an endoscopic exploration and excision, a large number of dacryoliths were exposed. Pathology indicated amorphous pink material and multinucleated giant cell reaction in the fibrous tissue.CONCLUSIONThis case showed amyloidosis in localized form mimicking dacryolith with nasolacrimal duct obstruction. In clinical practice, we should be aware of the possibility of localized amyloidosis in the nasolacrimal excretory system. 相似文献