鼻内镜下治疗慢性泪囊炎

目的：总结鼻内镜下手术治疗慢性泪囊炎和术中切开泪囊时瘘口处理的经验。方法：选择鼻泪管堵塞、慢性泪囊炎（包括术后复发）患者90例、105眼，均行鼻内镜下处理。造瘘口采用EC耳脑胶粘合固定成形72眼，术中置硬膜外导管10眼，用银夹吻合泪囊后瓣与鼻黏膜瓣13眼，造瘘口用碘仿纱条填塞扩张成型5眼，用一次性5?ml注射器乳头将前后瓣撑开成型5眼。同期行鼻中隔高位偏曲矫正7眼，钩突肥大切除10眼，中鼻甲前端息肉样变切除9眼，鼻息肉6眼。结果：完全无溢泪92眼，好转8眼，无效5眼，有效率95.24% 。结论：泪囊鼻腔造口术造瘘口的处理可根据术者的习惯及手术经验、设备条件及术中切开泪囊后泪囊鼻腔黏膜瓣具体情况而定。

Endoscopy in treatment of dacryocystitis

To summarize the experience of dacryorhinocystotomy with nasal endoscopy for chronic dacryocystitis. Methods: Endoscopic dacryorhinocystotomy was performed for 90 patients (105 eyes) with chronic dacryocystitis or nasolacrimal duct obstruction from August 2000 to December 2004. EC biosythesis ear brain glue was used for 72 eyes; epidural tube for 10 eyes; silver clip for 13 eyes; and injector nipple for 5 eyes. Simultaneously, high deviation of nasal septum was corrected in 7 patients; hypertrophic uncinate process was excised in 10 patients; polypous middle turbinate was excised in 9 patients; and polyp was excised in 6 patients. Results: Ninety two eyes were cured, 8 had effective; and 5 had no effect. The response rate was 95.24%. Conclusion: The ways of dealing with anastamosis should be chosen according to operator′s experience and dacryocyst mucosa.