鼻内窥镜下鼻腔泪囊造口术联合治疗泪道阻塞

目的探讨经鼻内镜泪囊造孔术联合术中应用丝裂霉素C治疗鼻泪管阻塞的疗效和安全性。方法对56例鼻泪管阻塞患者（81眼）,随机分为治疗组（n=41）和对照组（n=40）,施行经内窥镜鼻腔泪囊造口术。术中经鼻腔径路进入泪囊,手术切除鼻黏膜,鼻泪骨,上颌骨额突,完整切除泪囊内壁。治疗组术中接受浓度为0.5 mg/ml的丝裂霉素C棉片放置在骨孔位置10min。对照组术中接受0.9%氯化钠棉片10min。结果所有患者均成功接受了手术。随访6-24个月,治疗组手术成功率为95.2%。对照组成功率为84.5%。两组比较差异有显著性（P〈0.05）。未发现丝裂霉素C引起的并发症。结论经内镜鼻腔泪囊造口术联合术中应用丝裂霉素C治疗鼻泪管阻塞是安全有效的方法。

Endoscopic endonasal dacryocystorhinostomy with adjunctive mitomycin C in nasolacrimal duct obstruction

Objective To explore the outcome and safety of endonasal dacryocystorhinostomy（EN-DCR） with the use of adjunctive mitomycin C（MMC） in nasolacrimal duct obstruction.Methods Fifty-six consecutive patients（81eyes）underwent a EN-DCR procedure,with an endonasal approach to the lacrimal sac,surgical removal of nasal mucosa,lacrimal bone,and a fragment of the frontal process of the maxilla.The medial wall of the lacrimal sac was removed completely,and a cottonoid soaked in MMC at 0.5mg/ml was placed at the osteotomy site for 10 minutes.Results The EN-DCR procedure with adjunctive MMC was successful in 212（95.4%） cases.No complications involving MMC occured during 1-3 year（mean 1.6 years） follow-up.Conclusions Results suggest that EN-DCR with MMC is a safe and successful procedure for the treatment of nasolacrimal duct obstruction.