泪囊鼻腔吻合联合泪道内窥镜下泪小管置管治疗泪囊囊肿

目的探讨泪囊鼻腔吻合联合泪道内窥镜下泪小管置管术治疗泪囊囊肿的效果。方法泪囊囊肿16例（16眼）在局麻下行泪囊鼻腔吻合术的同时应用泪道内窥镜系统对泪小管泪总管进行检查,针对阻塞部位进行激光或电钻治疗后,逆行植入环形泪小管内硅胶管。1周拔除引流管,拆除皮肤缝线。3~6个月拔除泪小管内硅胶管。术后随访6个月~2 a,观察术后囊肿治愈率,泪道冲洗通畅情况及泪溢症状是否改善。结果泪囊囊肿全部消失,有效率100%。泪道冲洗通畅14例占87.5%,2例有部分回流占12.5%。以上患者溢泪症状基本消失。结论泪囊鼻腔吻合联合泪道内窥镜下泪小管置管术治疗泪囊囊肿的疗效显著。

Therapy of cyst of lacrimal sac by dacryocystorhinosctomy combined with intubation in lacrimal canaliculus under dacryoendoscopy

Objective To investigate therapeutic effect of cyst of lacrimal sac by dacryocystorhinosctomy combined with intubation in lacrimal canaliculus under dacryoendoscopy. Methods Sixteen cases（16 eyes）with cyst of lacrimal sac were treated by dacryocystorhinosctomy under local anesthesia.The lacrimal canaliculus were examined under dacryoendoscopy.Laser or micro drills were used to eliminate obstruction,and then the silicone tube was implanted.The drainage tubes were extracted and skin sutures were removed 1 week after operation.Extubation was performed three to six months after operation.All cases were follwed up for 6 to 24 months.The cure rate of cyst after operation,lacrimal irrigation and symptom of epiphora were observed. Results All cysts disappeared,the cure rate was 100%.Lacrimal irrigation of 14 cases（87.5%）were free,2 cases（12.5%） had reflux.All patients were free of epiphora. Conclusion The therapeutic effect of cyst of lacrimal sac by dacryocystorhinosctomy combined with intubation in lacrimal canaliculus under dacryoendoscopy is significant.