泪囊在鼻内镜泪囊鼻腔造口术中的解剖学研究及临床应用

目的 探讨经鼻内镜泪囊鼻腔造口术中泪囊在鼻腔外侧壁的解剖学定位.方法 对12具(24侧)成人尸头的泪囊在鼻腔外侧壁上的投影位置进行解剖学测量,为62例(85侧)慢性泪囊炎鼻泪管阻塞患者行经鼻内镜鼻腔泪囊造口术.结果 解剖学测量结果提示,15侧(62.5%)泪囊上界位于中鼻甲腋上方,9侧(37.5%)泪囊上界位于中鼻甲腋下方.临床结果:62例(85侧)术后随访6个月以上,治愈50例(70侧,82.3% ),好转8例(9侧,10.6%),无效4例(6侧,7.1%),总有效率为92.9%.结论 以中鼻甲腋前上0.7 cm为上界,腋前下0.3 cm为下界,钩突前缘向上延线为泪囊后界定位泪囊进行鼻腔泪囊造口为较佳选择.

Anatomy of lacrimal sac to endoscopic transnasal dacryocystorhinostomy

Objective To provide anatomical localization for endoscopic transnasal dacryocystorhinostomy. Methods Twelve adult cadavers(24 sides) were studied on the projection anatomy of lacrimal sac on the lateral wall of nasal cavity. Sixty-two patients (85 sides) with chronic dacryocystitis and nasolacrimal duct obstruction were treated by endoscopic transnasal dacryocystorhinostomy. Results Fifteen adult cadavers sides (62.5%) lacrimal sac upper bound were higher than the insertion of middle turbinate, 9 adult cadavers sides (37.5%) lacrimal sac upper bound were lower than the insertion of middle turbinate. During a post-operative follow-up of 6 months, 50 patients (70 sides 82.3%) were cured, 8 (9 sides 10.6%) had improvement, and 4 (6 sides 7.1%) were invalid. The total efficiency was 92.9%. Conclusion Upper bound of the lacrimal sac was 0.7 cm up the insertion of middle turbinate .Lower bound of the lacrimal sac was 0.3 cm under the insertion of middle turbinate. After bound of the lacrimal sacs was front of the uncinate.