Bolger W E, Parsons D S, Mair E A, Kuhn F A
Department of Otolaryngology Head and Neck Surgery, Wilford Hall US Air Force Medical Center, Lackland Air Force Base, Tex.
Arch Otolaryngol Head Neck Surg. 1992 Nov;118(11):1179-84. doi: 10.1001/archotol.1992.01880110047011.
Injury to the lacrimal drainage system with resultant epiphora is a complication of functional endoscopic sinus surgery. A study of 24 patients was conducted to determine the incidence and significance of lacrimal drainage system injuries during functional endoscopic sinus surgery. Intraoperative testing demonstrated seven occult injuries (15%) in 46 endoscopic procedures. Postoperative testing demonstrated diversion of lacrimal drainage into the middle meatus in two patients and spontaneous healing of the injured lacrimal drainage system with restoration of normal drainage in three of the patients available for follow-up testing. In no patient did epiphora develop. It is concluded that the nasolacrimal drainage system is in close proximity to the dissection cavity during functional endoscopic sinus surgery and, hence, is at risk for inadvertent injury. Occult damage to the nasolacrimal drainage system would appear to be a common event during functional endoscopic sinus surgery; however, the complication of postoperative epiphora is rare.
泪道引流系统损伤并导致溢泪是功能性鼻内镜鼻窦手术的一种并发症。对24例患者进行了一项研究，以确定功能性鼻内镜鼻窦手术期间泪道引流系统损伤的发生率和意义。术中检查显示，在46例内镜手术中有7例隐匿性损伤（15%）。术后检查显示，2例患者泪道引流改道至中鼻道，在可供随访检查的患者中，有3例受伤的泪道引流系统自行愈合，恢复正常引流。无一例患者出现溢泪。得出的结论是，在功能性鼻内镜鼻窦手术期间，鼻泪引流系统紧邻手术解剖腔，因此有意外损伤的风险。鼻泪引流系统的隐匿性损伤在功能性鼻内镜鼻窦手术期间似乎是常见事件；然而，术后溢泪的并发症很少见。
