Yigit Ozgur, Cinar Ugur, Coskun Berna Uslu, Akgul Gokhan, Celik Deniz, Celebi Irfan, Dadas Burhan
Department of Otolaryngology, Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey.
Rhinology. 2004 Mar;42(1):19-22.
The lacrimal drainage system (LDS) is vulnerable to surgical trauma during rhinoplasty. We aimed to investigate the possible effects of the low lateral osteotomies on the LDS during rhinoplasty using active transport dacryocystography (ATD) at the late postoperative stage. Twenty patients who underwent open rhinoplasty were evaluated by ATD between the sixth and seventh postoperative months. Presence of the LDS dehiscence and the absence of the passage of the contrast material into the inferior meatus were noted as signs of injury to the LDS in ATD. The proximity of the osteotomy site to the LDS was measured using three different measurements in ATD. The distance from the lacrimal fossa to the lateral osteotomy site, the distance from the inferior meatus to the lateral osteotomy site and the distance from the middle point of the lacrimal fossa and inferior meatus to the lateral osteotomy site were measured. The anatomic integrity of the bone structure around the LDS was preserved in all patients and free drainage of contrast media from the fossa lacrimalis to inferior meatus was observed in ATD evaluation of all patients. The average distance from the LDS to the lateral osteotomy site was found to be between 7-8.8 mm. In conclusion, the low lateral osteotomy is a safe method in order to avoid trauma to the LDS, and ATD seems an appropriate diagnostic technique in evaluation of the LDS after rhinoplasty.
泪道引流系统（LDS）在鼻整形术中易受手术创伤。我们旨在利用术后晚期的主动转运泪囊造影术（ATD）研究鼻整形术中低位外侧截骨术对LDS的可能影响。对20例行开放式鼻整形术的患者在术后第六至七个月期间进行了ATD评估。在ATD中，LDS裂开的存在以及造影剂未进入下鼻道被视为LDS损伤的迹象。在ATD中使用三种不同的测量方法来测量截骨部位与LDS的接近程度。测量从泪窝到外侧截骨部位的距离、从下鼻道到外侧截骨部位的距离以及从泪窝和下鼻道中点到外侧截骨部位的距离。所有患者LDS周围骨结构的解剖完整性均得以保留，并且在所有患者的ATD评估中均观察到造影剂从泪囊自由引流至下鼻道。发现LDS到外侧截骨部位的平均距离在7 - 8.8毫米之间。总之，低位外侧截骨术是一种避免LDS创伤的安全方法，并且ATD似乎是鼻整形术后评估LDS的一种合适的诊断技术。
