泪囊鼻腔吻合术失败后的处理

目的：探讨泪囊鼻腔吻合术失败病例的处理方法。方法：对16例鼻腔泪囊吻合失败者再行吻合。探通后插入塑料管，塑料管上端缝上5-0丝线通过小泪小管缝合固定在小泪小点旁，6周后拔管。结果：10例患者泪道通畅。6例患者拔管1-4周后吻合口再次阻塞。行鼻内窥镜下鼻粘膜及疤痕组织切除 植皮术，泪道通畅。结论：对中，下鼻甲中度肥大，鼻中隔中度偏曲。中度萎缩性鼻炎患者行泪囊鼻腔吻合术时，吻合口插入塑料管，6周后拔管，能预防吻合口阻塞。插管后失败病例行鼻内窥镜下鼻粘膜及疤痕组织切除 植皮术可使吻合口通畅。

The Treatment of Lacrimal Sac and Nasal Cavity Anastomosis Surgery Failed Cases

Objective:To probe into the treatment method of lacrimal sac and nasal cavity anastomosis surgery failed cases.Methods:Proceeding anastomose for 16 loser of lacrimal sac and nasal cavity anastomose surgery again.Insert the silent stock tube after visitting openly,Silent stock tube top sew last 5-0 silk thread and sew up and fix by upper lacrimal puncta through upper lacrimal canaliculi,pull out the silent stock tube 6 weeks later.Results:10 patients lacrimal passages is unobstructed,of 6 patients the identical mouth blocks again after pulling out the silent stock tube for 1-4 weeks,proceed nasal mucosa and scar organization excise + skin grafting through nose endoscope,the lacrimal passage is unobstructed.Conclusions:Proceed lacrimal sac nasal cavity anastomosis surgery for mezzo corpulent of the middle nasal concha and the inferior nasal concha patients,deviation of the middle nasal septum patients,mezzo atropic rhinitis patients,insert the silent stock tube in anastomosis mouth,pull out the silent stock tube 6 weeks later,it can prevent obstract of anastomosis mouth.proceed nasal mucosa and scar organization excise + skin grafting through nose endoscope for those lose's case after inserting the silent stock tube,possibility unobstract anastomosis mouth.