慢性泪囊炎患者应用鼻内镜下鼻腔泪囊造口术的临床效果及对安全性的影响

目的探讨慢性泪囊炎患者应用鼻内镜下鼻腔泪囊造口术的临床效果及安全性。方法选取2018年1月至2019年12月因慢性泪囊炎于本院接受治疗的46例患者为研究对象,随机分为研究组与对照组,各23例。对照组接受泪囊鼻腔造口治疗,研究组取鼻内镜下鼻腔泪囊造口术治疗,比较两组临床效果、手术指标以及并发症发生情况。结果研究组治疗总有效率高于对照组(P<0.05);研究组术中出血量少于对照组,手术及住院时间均短于对照组(P<0.05);研究组并发症总发生率低于对照组(P<0.05)。结论慢性泪囊炎患者采用鼻内镜下鼻腔泪囊造口术治疗效果显著,并发症较少,安全性较高,值得临床推广应用。     

再次泪囊鼻腔吻合术的临床分析

本文报告了１０例慢性泪囊炎患者，行泪囊鼻腔吻合术后，发生吻合口阻塞，再次行泪囊鼻腔吻合术，手术治愈率１００％。并就其阻塞的原因、防止方法、治疗方法进行了讨论     

Paediatric dacryocystorhinostomy

Of 258 cases of dacryocystorhinostomy performed on children in the period September 1981 to September 1991, 130 were for simple, unresolved congenital nasolacrimal duct obstruction. Other indications for surgery included punctal agenesis, lacrimal fistula, post-traumatic and post-inflammatory canalicular obstruction. Of 177 children without canalicular pathology, 171 (96%) were relieved of symptoms with one operation, without canalicular intubation. Of 81 cases with canalicular disease, 55 of 70 (79%) who underwent DCR plus canalicular intubation, and 10 of 11 who underwent DCR plus Lester-Jones tube, were substantially improved with one operation. No child required peroperative or postoperative blood transfusion. Dacryocystorhinostomy in childhood, in experienced surgical hands, is a safe procedure, achieving relief of symptoms in most cases, particularly in the absence of canalicular disease.     

普通额镜下鼻内激光泪囊鼻腔造孔术治疗慢性泪囊炎

报告在普通额镜下以YAG激光经鼻腔行泪囊鼻腔造孔术，治疗慢性泪囊炎患者37例（45眼），经3～24个月的随访观察，泪道阻塞均解除，有效率为95．6％，治愈率为88．9％。本手术具有损伤小，操作简便，快捷，术后反应轻，并发症少等优点。并对手术方法及影响疗效的因素进行了探讨。     

An epidemiological study on patients undergoing dacryocystorhinostomy

Dacryocystorhinostomy is performed in patients with naso-lacrimal duct obstruction to bypass the site of obstruction so as to relieve the patient of the irritating and socially embarrassing symptoms of epiphora. We discuss the various epidemiological aspects especially the vast difference by which the females out-number the males in patients undergoing DCR and the likely explanations for this difference in our study on 74 patients which underwent DCR in our institute.     

Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction

PurposeThis study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique.MethodsWe retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient''s subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon.ResultsFunctional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test).ConclusionsThe success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.     

Utilidad de las curas locales tras dacriocistorrinostomía láser

Introduction and objectivesEpiphora caused by nasolacrimal drainage system obstruction is the main indication for dacryocystorhinostomy (DCR). So are chronic conjunctivitis and dacryocystitis from the same origin. Nasal endoscopy and the introduction of laser assisted DCR have facilitated the performance of the technique. However, it requires complex and expensive equipment, so there are still supporters of the traditional external procedure.The aim of this work was to study the effectiveness and usefulness of local postoperative care in laser DCR final result.Material and methodsWe studied a group of 96 patients diagnosed with epiphora secondary to stenosis-occlusion of the nasolacrimal duct. Of these, 32 patients underwent surgery in both eyes, making a total of 128 cases. The surgery was performed in a private setting between January 1999 and December 2008. The 128 cases were divided into 2 groups: 59 cases in which between 4 and 6 postoperative cures were given in the 2 months following the surgery, and another group of 69 cases in which a single cure was given approximately 7 days after surgery. The final assessment of the outcome of the intervention was done in all cases between 24-30 months after surgery.ResultsIn 27 cases out of 128 (79% success), there was a restenosis of tear drainage. No statistically significant differences were found between the 2 groups.ConclusionsIn the sample of patients that were intervened using laser assisted DCR, implementation of postoperative cure was irrelevant in the success of the intervention.     

内窥镜下缝合法用于泪囊鼻腔吻合的临床研究

目的：探讨内镜下经鼻泪囊鼻腔吻合术（ET-DCR）中缝合技术的临床价值。方法选择慢性泪囊炎患者85例98眼,按照随机数字表法分为两组（当双眼均为泪囊炎时,确定右眼是对照组还是观察组,左眼为另一组）对照组（不缝合）和观察组（缝合）。所有患者均随访超过12个月。比较两组治愈率和肉芽组织形成情况。结果观察组治愈率96．00％（48／50）,高于对照组的81．25％（39／48）（χ^2＝5．35,P＜0．05）。在随访期间,观察组有14．00％（7／50）、对照组有31．25％（15／48）患者吻合口周围发生肉芽组织增生（χ^2＝4．19,P＜0.05）。结论应用缝合技术的ET-DCR可减少肉芽组织形成,提高手术成功率,特别是对小泪囊患者可能存在特别优势。     

鼻内镜下鼻腔泪囊造孔术

经鼻内镜鼻腔泪囊开放术治疗慢性泪囊炎,疗效比传统的鼻外进路手术有所提高,而且可以同时处理鼻腔鼻窦病变,避免颜面部瘢痕,出血少、创伤小、术后反应轻。我科于1999年6月-2004年4月共收治慢性泪囊炎患者24例,现报告如下。     

Transcanalicular laser-assisted dacryocystorhinostomy with diode laser

This article compares the efficacy of transcanalicular laser assisted dacryocystorhinostomy (TL DCR) with conventional external dacryocystorhinostomy (Ex DCR). All patients were randomly divided into two groups – Group A included patients who underwent TL DCR and Group B included patients who underwent Ex DCR. 168 operations were done in a total of 163 patients; 79 patients in group A and 84 patients in group B. The overall success rate was 90.12% in group A and 95.40% in group B. The mean total surgical time was 17.41 min in group A and 49.49 min in group B. The duration of stay in hospital was about 3 hours for group A and about 48 hours for group B. Intra and post operative complications were more in group B than in group A. TL DCR can offer a minimally invasive technique with comparable results and better patient satisfaction than Ex DCR.