鼻内镜下手术治疗慢性泪囊炎的经验体会

目的 探讨鼻内镜下手术治疗慢性泪囊炎的经验。方法 选择2006年5月至2010年3月收治的213例(225眼)慢性泪囊炎、鼻泪管堵塞患者，其中慢性泪囊炎行颜面部切口手术复发25眼，均行鼻内镜下手术治疗。造瘘口均采用EC耳脑胶黏合固定成形。结果 213例(225眼)中，同期行鼻中隔高位偏曲矫正33眼，钩突肥大切除20眼，中鼻甲前端息肉样变切除19眼，鼻息肉切除16眼。术后完全无溢泪199眼，好转19眼，无效7眼。有效率96.8% 。结论 泪囊内壁黏膜完全切开且无张力外翻是手术成功的关键，造瘘口行EC耳脑胶吻合牢固可靠。术后定期鼻内镜下换药是手术治疗不可缺少的环节。

Endoscopic surgery for chronic dacryocystitis

Objective To gain experience in curing chronic dacryocystitis under endoscopic surgeries and to explore the qualities of the anastomosis by applying Ear-brain glue after incising the dacryocyst. Methods 213 patients (225 eyes) underwent endoscopic dacryocystorhinostomy between May 1, 2006 and March 31, 2010 because of sufferings of chronic dacryocystitis or nasolacrimal duct obstruction (among them, 25 eyes had recrudescence of chronic dacryocystitis after facial incision surgeries). Of the 213 cases, 16 eyes had nasal polyps; 33 high deviation of nasal septum, rectified; 20 uncinatus hypertrophy, excised; 19 nasal polyps hyalinosis at forward of the middle turbinate, removed. All the anastamoses were treated with ear-brain glue. Result 199 eyes were completely cured without any epiphora, 19 highly improved and 7 eyes proved to be ineffective. Conclusion 1) The most important steps are to locate and incise the lacrimal sac during dacryorhinocystotomy operation. 2) It is an indispensible step for surgical therapy to change dressings at regular intervals under nasal endoscopy. 3) It is reliable and stable to treat the fistulas with Ear-brain glue.