Struck H G, Weidlich R
Klinik und Poliklinik für Augenheilkunde der Martin-Luther-Universität Halle-Wittenberg.
Ophthalmologe. 2001 Jun;98(6):560-3. doi: 10.1007/s003470170119.
Dacryocystitis in infants is a serious complication of congenital, but seldom of acquired nasolacrimal duct obstructions. If conservative treatment fails, dacryocystorhinostomy (DCR) appears to be effective. The indications, special clinical history and results will be reviewed.
From 1/1970 to 2/2000, a total of 72 children (56 male, 16 female) with persistent dacryocystitis (18 bilateral) were treated surgically by DCR and were continuously documented. The patients ranged in age from 10 months to 14 years old (mean age 4.9 years). Included in our study were 66 children (52 male, 14 female) with 84 surgically treated lacrimal ducts (46 right eyes, 38 left eyes) who underwent control examinations.
The cause of dacryocystitis was congenital obstruction in 63 children and trauma (maxillary fracture) in 3 children, respectively. Of these, 20 children (30.3%) had additional anomalies of the lacrimal system, 21 (31.8%) systemic malformations and 8 out of the 66 children (12.1%) had a family history of nasolacrimal duct obstruction. Since 1985 the surgical procedures have been performed under microsurgery conditions and since 1998 sometimes with a transcanalicular laser-assisted technique. We found a functional success rate (with complete resolution of symptoms) of 90.4% (76 out of 84 lacrimal ducts) over follow-up periods ranging from 1 month to 12 years (average 1.6 years).
Patients with persistent dacryocystitis due to congenital nasolacrimal duct obstruction have a prevalence of further nasolacrimal abnormalities and a family history. The dacryocystorhinostomy of infants requires minimal invasive (sometimes laser-assisted) techniques. In the case of persistent dacryocystitis, DCR is indicated after the age of 1 year and has the same success rate in infants as in adults (90-95%).
婴儿泪囊炎是先天性鼻泪管阻塞的严重并发症，但后天性鼻泪管阻塞引起的情况较少见。若保守治疗失败，泪囊鼻腔吻合术（DCR）似乎有效。现将其适应证、特殊临床病史及治疗结果进行综述。
1970年1月至2000年2月，共有72例持续性泪囊炎患儿（男56例，女16例，其中18例为双侧）接受了DCR手术治疗，并持续记录相关情况。患儿年龄从10个月至14岁不等（平均年龄4.9岁）。我们的研究纳入了66例患儿（男52例，女14例），其84条泪管接受了手术治疗，并进行了对照检查。
63例患儿泪囊炎病因是先天性阻塞，3例是外伤（上颌骨骨折）。其中，20例患儿（30.3%）存在泪器系统其他异常，21例（31.8%）有全身畸形，66例患儿中有8例（12.1%）有鼻泪管阻塞家族史。自1985年起手术在显微手术条件下进行，1998年起有时采用经泪小管激光辅助技术。随访1个月至12年（平均1.6年），我们发现功能成功率（症状完全缓解）为90.4%（84条泪管中的76条）。
先天性鼻泪管阻塞导致的持续性泪囊炎患者存在鼻泪管其他异常及家族史。婴儿泪囊鼻腔吻合术需要微创（有时采用激光辅助）技术。对于持续性泪囊炎，1岁后可行DCR，其在婴儿中的成功率与成人相同（90% - 95%）。
