Cho Y S, Song H Y, Ko G Y, Yoon C H, Ahn H S, Yoon H K, Sung K B
Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Vasc Interv Radiol. 2000 Nov-Dec;11(10):1319-24. doi: 10.1016/s1051-0443(07)61309-8.
To evaluate the safety and effectiveness of balloon dilation for the treatment of congenital lacrimal system obstruction.
Fluoroscopically guided balloon dilation was attempted in 20 eyes of 16 patients with an age range of 12-78 months (mean, 33 mo) for congenital lacrimal system obstruction. Fifteen eyes had complete obstruction at the valve of Hasner, three eyes had completely obstruction at the junction between the lacrimal sac and the nasolacrimal duct, and two eyes had partial obstruction at the nasolacrimal duct. Under general anesthesia, a ball-tipped guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and pulled out through the naris with use of a hook. A deflated 3-mm-diameter balloon catheter was then advanced in a retrograde direction and the balloon was dilated. Every patient underwent an ophthalmic evaluation before the procedure and was scheduled to be followed with office examination at 1, 3, and 6 months after the procedure.
There were no major complications. "Technical success" was defined as free passage of contrast medium through the entire lacrimal system to the nasal cavity. The procedure failed in one eye. After balloon dilation, all 19 eyes in which technical success was achieved showed improvement of epiphora. During the follow-up period of 2-33 months (mean, 16 mo), all eyes maintained improvement of epiphora and needed no further treatment.
Balloon dilation is a safe and effective therapeutic technique for the treatment of congenital lacrimal system obstruction.
评估球囊扩张术治疗先天性泪道系统阻塞的安全性和有效性。
对16例年龄在12至78个月（平均33个月）的先天性泪道系统阻塞患者的20只眼进行了荧光透视引导下的球囊扩张术。15只眼在哈氏瓣膜处完全阻塞，3只眼在泪囊与鼻泪管交界处完全阻塞，2只眼在鼻泪管处部分阻塞。在全身麻醉下，将球头导丝经上泪小点插入鼻腔下鼻道，并用钩子经鼻孔拉出。然后将一个未充气的直径3毫米的球囊导管逆行推进并扩张球囊。每位患者在手术前均接受眼科评估，并计划在术后1、3和6个月进行门诊检查。
无重大并发症。“技术成功”定义为造影剂能自由通过整个泪道系统进入鼻腔。有一只眼手术失败。球囊扩张术后，所有19只获得技术成功的眼睛均显示溢泪症状改善。在2至33个月（平均16个月）的随访期内，所有眼睛的溢泪症状均持续改善，无需进一步治疗。
球囊扩张术是治疗先天性泪道系统阻塞的一种安全有效的治疗技术。
