经鼻内镜鼻腔泪囊造口术探讨

目的探索解决泪囊阻塞的新手术方法、分析其治疗难点。方法采用经鼻内镜鼻内开放手术治疗慢性泪囊炎、面部外伤和手术等多种原因导致的鼻泪管阻塞16例(16眼),术后常规泪道冲洗。结果随访6个月～1年,14例患者溢泪和溢脓症状消失;1例术后3个月出现溢泪,再次在内镜下扩大造口;1例无效,术后继续溢泪。所有患者未见手术并发症。结论经鼻内镜泪囊鼻腔造孔术是治疗鼻泪管阻塞的较好方法,术中和术后需要注意泪囊的大小、位置是否正常;是否存在上颌骨额突骨质增生;是否存在泪囊壁肥厚等异常。

DACRYOCYSTORHINOTOMY UNDER ENDOSCOPE

Objective To explore new method and analysis nedus of treatment in obstructive lacrimal sac. Methods 16 cases with obstructive of naso lacrimal duct were caused by chronic dacryocystitis, facial trauma and surgery, they were treated with endoscopic surgery by intranasal approach and irrigated the lacrimal passage after sur- gery. Results After follow up of 6 months to 1 years, epiphora and pyorrhea of 14 cases were disappear; 1 case who had epiphora after 3 months had surgery again. 1 case was ineffective and still had epiphora ; all of the patient had no complication. Conclution Dacryocystorhinotomy under endoscope was a good treatment of obstructive lacrimal sac. It should be notice the site and position of the lacrimal sac intraoperation and postoperation, whether there is hyperso- teogery of frontal process maxilla, whether there is hypertrophy of wall of lacrimal sac.