鼻内镜下鼻泪管阻塞激光疏通术的远期疗效观察

目的探讨鼻内镜下鼻泪管阻塞的有效治疗方法。方法用带针芯的泪道套管针按常规泪道插管术,自上泪点插至鼻泪管阻塞处,拔出针芯,输入磷酸钛氧钾激光导光纤维,发射激光,气化疏通泪道。鼻内镜直视下,同期处理引起鼻泪管阻塞的鼻腔、鼻窦原发病变。结果各种原因所致的鼻泪管阻塞139例(158只眼),其中单纯泪管阻塞96例(107只眼)、慢性泪囊炎33例(39只眼)、泪道置管术后再阻塞10例(12只眼)。一次性手术成功137只眼,治愈率86.7%。结论鼻内镜下激光泪道疏通术治疗鼻泪管阻塞,可同期处理引起鼻泪管阻塞的鼻腔、鼻窦原发疾病。对提高远期疗效有独特优点,方法简便,适应证广,组织损伤小,面部无瘢痕,有推广运用价值。

Long-term therapeutic effect of endoscopic laser deoppilation on nasolacrimal duct obstruction

Objective To observe the endoscopic surgery for the treatment of nasolacrimal duct obstruction. Methods Conventional method of lacrimal passage was used firstly, the needle set with core needle was then inserted into the nasallacrimal duet obstruction site and the needle core was pulled out with KTP laser optical fiber being put in. The laser light was send out and the nasolacrimal duct was dredged by vaporization. During the same period, the primary lesion in paranasal sinuses and nasal cavity was treated under transnasal endoscopy. Results In 139 cases （ 158 eyes） with nasolacrimal duct obstruction, 96 cases （107 eyes） was duct obstruction, 33 eases （39 eyes） was chronic dacryocystitis, 7 cases （9 eyes） was obstruction after dacryocystorhinostomy. One hundred and thirty-seven patients were cured successfully at one time with the cure rate being 86.7%. Conclusions Lasertubation in treating the nasolacrimal duct obstruction under transnasal endoscopy could simultaneously deal with the nasal cavity and the primary diseases of paranasal sinuses, which was useful for improving the long-term effect. It was a simple and microinvasive method with direct approach and clear view and could be applied in clinic. （Chin J Ophthalmol and Otorhinolaryngol ,2011,11：39-41 ）