Unlu H H, Goktan C, Aslan A, Tarhan S
Otorhinolaryngology Department, Celal Bayar University, School of Medicine, Manisa, Turkey.
Otolaryngol Head Neck Surg. 2001 Mar;124(3):308-12. doi: 10.1067/mhn.2001.112433.
In order to evaluate the lacrimal drainage system injury after functional endoscopic sinus surgery, surgical records and postoperative active transport dacryocystography imaging of 31 patients were analyzed. Presence of the lacrimal bone dehiscence and no passage of the contrast material into the inferior meatus were noted as the signs of injury to the lacrimal canal on active transport dacryocystography. Bony dehiscence was detected in 53.2% of the operated sides but 20% of the nonoperated sides. No passage of the contrast material into the inferior meatus was observed in 14.9% of the operated sides. There were no cases of epiphora postoperatively. The lacrimal drainage system injury was more frequently observed on the left sides operated. We conclude that lacrimal drainage system injury might occur in various extents during functional endoscopic sinus surgery. However, it does not necessarily result in postoperative epiphora. Performing the middle meatal antrostomy in posteroinferior direction, and uncinectomy with backbiting forceps or a shaver might help in reducing the lacrimal injury. Active transport dacryocystography can be adopted as an alternative diagnostic tool in detection of the lacrimal injury.
为了评估功能性鼻内镜鼻窦手术后泪道系统损伤情况，分析了31例患者的手术记录及术后主动转运泪囊造影成像。主动转运泪囊造影时，泪骨裂开及对比剂未流入下鼻道被视为泪小管损伤的征象。手术侧泪骨裂开检出率为53.2%，非手术侧为20%。14.9%的手术侧未观察到对比剂流入下鼻道。术后无溢泪病例。左侧手术时泪道系统损伤更为常见。我们得出结论，功能性鼻内镜鼻窦手术期间可能会在不同程度上发生泪道系统损伤。然而，这不一定会导致术后溢泪。向后下方向进行中鼻道上颌窦造瘘术，并用咬骨钳或刨削器行钩突切除术可能有助于减少泪道损伤。主动转运泪囊造影可作为检测泪道损伤的一种替代诊断工具。
