先天性鼻泪管阻塞鼻泪管发育的解剖特征研究

目的：通过鼻泪管CT平扫联合三维重建技术分析先天性鼻泪管阻塞患儿鼻泪管发育的解剖特征。

方法：前瞻性病例对照研究。选取2018-09/2020-09就诊于保定市儿童医院眼科的单侧先天性鼻泪管阻塞患儿84例84眼，行鼻泪管CT平扫联合三维重建，测量双侧鼻泪管起始段、中段、末段骨性鼻泪管的横径、前后径，观察分析鼻泪管发育的解剖特征。

结果：鼻泪管CT平扫联合三维重建技术可清晰显示儿童先天性鼻泪管阻塞鼻泪管发育的解剖特征。纳入患儿患侧起始段骨性鼻泪管横径4.63±0.92mm，前后径6.03±1.08mm，中段骨性鼻泪管横径4.02±0.88mm，前后径5.42±1.10mm，末段骨性鼻泪管横径4.26±0.93mm，前后径5.66±1.02mm，健侧起始段骨性鼻泪管横径4.12±0.78mm，前后径5.60±1.02mm，中段骨性鼻泪管横径3.92±0.86mm，前后径5.24±1.04mm，末段骨性鼻泪管横径4.30±0.98mm，前后径5.52±1.04mm，骨性鼻泪管起始段患侧较健侧横径、前后径均扩大(P<0.01)，骨性鼻泪管中段和末段患侧较健侧均无明显变化(P>0.05)。

结论：先天性鼻泪管阻塞患儿患侧骨性鼻泪管发育较健侧存在差异，患侧起始段扩张较为明显。

Anatomical characteristics of nasolacrimal duct development in congenital nasolacrimal duct obstruction

AIM: To analyze the anatomical characteristics of nasolacrimal duct development in children with congenital nasolacrimal duct obstruction by nasolacrimal duct CT scan combined with three-dimensional reconstruction technology.

METHODS: Prospective case control study. Totally 84 children(84 eyes)with unilateral congenital nasolacrimal duct obstruction were treated in the Department of Ophthalmology of Baoding Children''s Hospital from September 2018 to September 2020. The nasolacrimal duct CT scan combined with three-dimensional reconstruction was performed. The transverse diameter and anterior posterior diameter of bilateral nasolacrimal duct were measured, and the anatomical characteristics of nasolacrimal duct development were observed and analyzed. Paired t-test was performed on the transverse diameter and anteroposterior diameter of bilateral nasolacrimal duct.

RESULTS: Nasolacrimal duct CT scan combined with three-dimensional reconstruction can clearly show the anatomical characteristics of nasolacrimal duct development in children with congenital nasolacrimal duct obstruction. The transverse diameter of bony nasolacrimal duct was 4.63±0.92mm, anterior posterior diameter was 6.03±1.08mm, the transverse diameter of middle bony nasolacrimal duct was 4.02±0.88mm, anterior posterior diameter was 5.42±1.10mm, the transverse diameter of final bony nasolacrimal duct was 4.26±0.93mm, anterior posterior diameter was 5.66±1.02mm. The transverse diameter of the bony nasolacrimal duct in the initial segment of the contralateral side was 4.12±0.78mm, the anteroposterior diameter was 5.60±1.02mm, the transverse diameter of the bony nasolacrimal duct in the middle segment was 3.92±0.86mm, the anteroposterior diameter was 5.24±1.04mm, the transverse diameter of the bony nasolacrimal duct in the final segment was 4.30±0.98mm, the anteroposterior diameter was 5.52±1.04mm. The transverse diameter and anteroposterior diameter of the affected side were larger than those of the healthy side and enlarged(P<0.01). There was no significant difference between the affected side and the healthy side(P>0.05).

CONCLUSION:The development of bony nasolacrimal duct in the affected side of congenital nasolacrimal duct obstruction is different from that in the healthy side. The initial segment of the affected side expanded obviously.