A clinical application of laser direction in anastomosis for inferior canalicular laceration

Canalicularlacerationisacommoncomplicationofeyelidtraumaandneedstoberepairedintime,otherwiseitwillleadtochronicepiphora.Searchingforthenasalbrokenendofthe laceratedlacrimalcanaliculiisakeystepincanalicular anastomosis,whichappearsparticularlyimportant whendeeplacerationoccurs.Traditionalsurgical methodinvolvesathree steppedproceduretofindthe brokenendandthenintubatethroughit.Since September2002,wehavedevelopedalaser directing approachtosearchforthenasalbrokenendof laceratedlacrimalcanaliculiin…     

Intranasal anatomy of the nasolacrimal sac in endoscopic dacryocystorhinostomy.

Intranasal surface anatomy is fundamental to the technique of endoscopic dacryocystorhinostomy. In the current literature the lacrimal sac is described as being situated anterior to the anterior end of the middle turbinate with between 0% and 20% of the sac above the insertion of the middle turbinate on the lateral nasal wall (the axilla of the middle turbinate). The aim of this study was to use CT dacryocystograms (DCGs) and CT scans to establish the relationship of the lacrimal sac to the lateral nasal wall. Forty-seven individual lacrimal sacs were measured in relation to the common canaliculus, and 76 were measured in relation to the insertion of the middle turbinate. Measurements taken from the long axis of the sac showed the mean height of the sac above the middle turbinate insertion was 8.8 mm (SD = 0.2, 95% CI = 1.3) and below it was 4.1 mm (SD = 2.3, 95% CI = 1.1). The average measurement of the sac above the com-mon canaliculus on CT DCGs was 5.3 mm (SD = 1.7, 95% CI = 0.56), whereas the average measurement below the common canaliculus was 7.7 mm (SD = 2, 95% CI = 1.3) (n = 47 CT DCGs). The findings in this study show that a major portion of the sac is locat-ed above the insertion of the anterior end of the middle turbinate and, in addition, that a significant part of the sac lies above the entry point of the common canaliculus. Knowledge of these findings can ensure that the sac is adequately exposed during dacryocystorhinostomy by removal of sufficient bone and mucosa above the anterior insertion of the middle turbinate.     

透明质酸钠在下泪小管断裂吻合术中的应用

目的探讨透明质酸钠在下泪小管断裂吻合术中寻找泪小管断端的应用价值。方法鼻腔用油沙条填塞后，从上泪小点注入透明质酸钠，寻找下泪小管鼻侧断端；从下泪小点注入透明质酸钠，寻找泪小管颠侧断端，行泪小管吻合术。结果本组患者16例(16只眼)，泪小管鼻侧断端经透明质酸钠标记明显，寻找断端的成功率100％，吻合手术顺利。术后随访6～12个月，14例患者治愈(87．5％)，2例未愈(12．5％)。结论注入透明质酸钠，寻找泪小管断端．简便易行．应作为寻找泪小管断端的首选方法．     

Canaliculocystostomy combining microsurgery and fibrin sealing of the anastomosis.

I present a method of using fibrin sealing for anastomosis in canaliculocystostomy. A microsurgical resection of the stenosis of the common canaliculus is followed by silicone intubation of the lacrimal apparatus and fibrin sealing of the anastomosis of the canaliculi and the lacrimal sac. The silicone tube is removed 6 months postoperatively. This technique obviates microscopic sutures, reduces operating time, and provides hemostasis. Of seven patients with monolateral stenosis of the common canaliculus in whom this technique was used and who were followed for a minimum of 3 years, only one had a restenosis.     

内镜下鼻腔泪囊吻合术临床疗效分析

目的:探讨内镜下鼻腔泪囊吻合术的临床疗效及术后满意度。方法:对我院2011年1月~2013年10月收治的80例慢性泪囊炎患者进行回顾性分析,将35例行内镜下鼻腔泪囊吻合术治疗的患者设为观察组,45例行传统泪囊鼻腔吻合术治疗的患者设为对照组,比较两组的治疗效果、术中出血量、住院时间、手术时间及术后瘢痕情况。结果:观察组治疗6个月、12个月后的有效率与对照组相比,差异均无统计学意义(p0.05);观察组术中出血量、住院时间及手术时间等均显著短于或低于对照组,差异有统计学意义(p0.05);观察组术后外观满意度显著高于对照组,差异有统计学意义(p0.05);观察组术后面部皮肤均无切口,对照组术后均存在切口瘢痕,其中25例患者的手术切口瘢痕明显。结论:在慢性泪囊炎患者中应用内镜下鼻腔泪囊吻合术的效果接近传统手术,且创伤小、手术操作快、可避免术后面部瘢痕,不影响美观,术后外观满意度较高,值得进一步推广。     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

端-侧吻合主动脉重建技术在婴儿主动脉缩窄合并心内畸形一期矫治术中的应用

目的比较婴儿主动脉缩窄(CoA)合并心内畸形一期矫治手术中采用端-侧吻合技术与扩大的端-端吻合技术的临床效果。方法 2008年1月至2011年7月广州市妇女儿童医疗中心共63例婴儿CoA合并心内畸形行一期矫治手术,按主动脉重建时的技术方法不同将63例患者分为两组,端-端吻合组:24例,男17例,女7例;年龄(4.6±2.9)个月,应用扩大的端-端吻合技术行手术治疗;端-侧吻合组:39例,男24例,女15例;年龄(3.4±2.6)个月,应用端-侧吻合技术行手术治疗。比较两组患者术后早期上、下肢动脉收缩压压差和围术期相关并发症发生情况。结果端-侧吻合组新生儿比率(23.1%vs.4.2%;χ2=3.979,P=0.045)、术前24 h内酸中毒比率(15.4%vs.0%;χ2=4.080,P=0.048)均高于端-端吻合组。术后端-端吻合组无死亡,端-侧吻合组死亡1例(2.6%)。端-侧吻合组术中停循环时间明显短于端-端吻合组[(18.6±2.7)min vs.(23.4±3.7)min,F=14.617,P=0.000]。端-端吻合组入心脏监护室(CICU)时上、下肢动脉收缩压压差<5 mm Hg、5～15 mm Hg、>15 mm Hg患者分别占20.8%、45.8%和33.3%,端-侧吻合组分别占97.4%、2.6%和0%,两组间差异有统计学意义(χ2=40.380,P=0.000)。术后24 h端-端吻合组上、下肢动脉收缩压压差<5 mm Hg、5～15 mm Hg、>15 mm Hg患者分别占45.8%、41.7%和12.5%,而端-侧吻合组占100%、0%和0%,两组间差异有统计学意义(χ2=26.620,P=0.000)。随访62例,随访时间2～36个月,所有患者均无血管瘤形成,无需再次手术处理的主动脉再狭窄。结论在婴儿CoA合并心内畸形的一期矫治手术中,与扩大的端-端吻合技术相比较,应用端-侧吻合技术可以安全、有效地显著降低术后早期出现的残余梗阻。     

Efficiency and therapeutic effect of modified pigtail probe in anastomosing lacerated lacrimal canaliculus

Objective: To investigate the necessity of modification to the traditional pigtail probe and evaluate its efficiency and therapeutic effect in scarehing the hasal cut ends and anastomosing the lacerated lacrimal carlaliculus.Methods: Eighty-seven patients (including 87 eyes) suffering from canalicular laceration were randomized into two groups:41 patients treated with tradidonal pigtail probes (Group A) and 46 with modified pigtail probes (Group B).During the reconstruction of the lacerated canaliculi,the traditional pigtail probe and the modified pigtail probe were used respectively to seek for the nasal cut ends of lacerated lacrimal canaliculi.Peripherally inserted central catheter (PICCTM) silicone tube with diameter of 0.95 mm was intubated as a stent for 4-6 months.The surgical outcomes were retrospectively analyzed after stent removal.Results: In Group B,the primary Success rate of searching the hasal cut ends of lacerated lacdmal canaliculi was 93.48% (43/46) and the final success rate was 97.83% (45/46).No false passage formed in Group B.Statistical significance was found between Group Aand Group B as the primary success rates of searching the nasal cut ends (χ2=10.522,P＜0.01) and the false passage forming rates were concerned (χ2=4.704,P＜0.05),whereasno significance was found between the two groups as the final success rates were concerned (χ2=0.007,P＞0.05).The mean time of searching the nasal cut ends of lacerated lacrimal canaliculi in Group B was (5.02±2.73) minutes and the mean time of operation was (33.9±4.84) minutes,and both were significantly shorter than those of Group A (t1=9.779,t2=10.700,P＜0.01).The cure rate of Group B was 95.65%,though higher than that of Group A,no statistical significance was found (Z=-1.007,P＞0.05).Totally,2 patients (2.30%) were found to be absent of common canaliculus and underwent bicanalicular hasal intubation in the two groups.Conclusions: Pigtail probes arc efficient and convenient apparatus for searching the nasal cut ends of the lacerated lacrimal canaliculi in the reconstruction of canalicular laceration.Necessary or proper modifications to the pigtail probes can minimize the risk of iatrogenic damages or complications and enhance the efficiency and therapeutic effect of canalicular repair.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

泪囊B型超声检查对泪囊鼻腔吻合术前评估的意义

目的:探讨泪囊B型超声检查对实施泪囊鼻腔吻合术前评估的价值。方法:对103例(112眼)泪囊鼻腔吻合术患者临床资料进行回顾分析,其中慢性泪囊炎86例(95眼),外伤性泪囊炎9例(9眼),探通失败的鼻泪管阻塞8例(8眼)。结果:103例(112眼)患者中100例(109眼)患者术中泪囊囊腔大小与B型超声影像学检查相符,只有3例(3眼)患者术中泪囊囊腔大小与B型超声影像学检查不符,符合率约97.32%。结论:泪囊B型超声检查对泪囊鼻腔吻合术前评估具有重要价值。     

Using Healon to identify the lumen of the sac in dacryocystorhinostomy

Sodium hyaluronate (Healon) injected into the lacrimal sac, facilitates a full-thickness cut of the lacrimal sac in cases in which it is difficult to identify the lumen of the sac. The sodium hyaluronate does not stain tissues, is effective for hemostasis, and is easily irrigated. A full-thickness cut of the lacrimal sac is required to ensure exact mucosal suturing in dacryocystorhinostomy. However, in cases involving a hypertrophic sac wall, a small lumen of the sac, or earlier perforation of the sac, it is sometimes difficult to identify the lumen during surgery. We describe how sodium hyaluronate, injected into the sac via a canaliculus, can facilitate identifying the lumen in this situation.