Dacryocystorhinostomy with temporary intubation using a Hatt set

During the period between June 1987 and March 1988 the authors performed 10 dacryocystorhinostomies with temporary intubation of the new efferent pathways, using a Hatt set. Three patients removed the set themselves during the early postoperative period. The authors evaluate thus seven successful intubations lasting two months. The observation period is six to eighteen months. In six patients the new efferent pathways are patent without signs of epiphora not even when lacrimation is irritated. One patient developed during the postoperative period torpid rhinitis persisting for two months and a block at the junction of the canaliculi. The results even in this small group are encouraging and the authors assume that temporary intubation with a Hatt set, which was very well tolerated by the patients, will enhances the success of this promising operation.     

Dacryocystorhinostomy in adolescents and young adults

ObjectiveTo study the relative frequency, causes, anatomical and functional outcomes and complications of dacryocystorhinostomy (DCR) in patients between the second and fifth decade of life.MethodA retrospective, nonrandomized, interventional study of a clinical series of 12 patients who underwent DCR from March 2007 to March 2009, performed by a single surgeon, with an age range between 10 and 48 years. Recorded data included age at surgery, date of surgery, gender, affected side, cause of obstruction, surgical technique, outcome and complications. The relative frequency of such cases over the total was calculated.ResultsDCR in patients between 13-48 years old represented 14.11% of the total (12:85). In this group 88.8% were females and in 75% surgery was on the right side. The most frequent cause of obstruction was low idiopathic obstruction (58.33%) whereas 41.66% were secondary. An external DCR was performed on 66.67% of patients and the rest were endonasal DCR. Anatomical success was achieved with resolution of symptoms in 91.6% of patients. One case had a hypertrophic scar.ConclusionAdolescents and young adults represent a significant percentage of cases undergoing DCR surgery. Both the external and endoscopic approach is shown to be a valid alternative for treating these patients, with good results and low incidence of complications.     

Dacryocystorhinostomy in Wegener's granulomatosis

Dacryocystorhinostomy was performed on two patients with Wegener's granulomatosis that had been quiescent for many years. Excellent results were attained, with elimination of dacryocystitis, complete relief from epiphora, and maintenance of a patent outflow tract. No wound necrosis occurred postoperatively, in contrast to a previous report in the literature. Our experience suggests that nasolacrimal duct obstruction in the setting of quiescent Wegener's granulomatosis can be treated safely and effectively with dacryocystorhinostomy.     

丝裂霉素C在泪囊鼻腔吻合术中应用的远期疗效观察

目的 :探讨丝裂霉素C (MMC)在泪囊鼻腔吻合术 (Dacryocystorhinostomy ,DCR)中的疗效 ,为提高DCR手术的远期疗效寻找一种有效的辅助措施。方法 :84例 ( 92眼 )泪道阻塞患者随机分组为对照组和治疗组 ,对照组采用常规的DCR手术 ,而治疗组在常规DCR术中用含0 0 2 %MMC的棉片置骨切孔区鼻粘膜和泪囊粘膜上 5分钟。结果 :术后平均随访 36 2 5± 7 2 4月 ( 3～ 70月 ) ,治疗组 48眼中 46泪道冲洗通畅 ,对照组 44眼中 35眼泪道冲洗通畅 ,Ka plan Meier生存曲线分析二组在统计学上有显著性差异 (P =0 0 47,log ranktest)。没有手术并发症。结论 :在DCR手术中应用MMC是一种能提高远期疗效的安全有效的辅助措施。     

粘弹剂在泪囊鼻腔吻合术中的应用

目的:探讨提高泪囊鼻腔吻合手术成功率及减少瘢痕的有效方法。方法:手术中应用粘弹剂从泪小点注入泪囊,根据泪囊的大小、形态及部位,切开泪囊,可争取得到较大的泪囊粘膜上瓣,并与鼻粘膜吻合。结果:共42例手术应用此方法,成功率97%。结论:粘弹剂的应用可有效提高手术成功率,减少手术时间及瘢痕长度。