Lekskul Apatsa, Khamapirad Boontium, Nimvorapun Taweekit
Department of Ophthalmology, Ramathibodi Hospital, Thailand.
J Med Assoc Thai. 2004 Sep;87(9):1082-6.
To propose a simple and low cost technique of using the simple materials in the operating room for silicone intubation in case of nasolacrimal duct obstruction in children after failed probing.
The study was a consecutive case series. Three patients with congenital nasolacrimal duct obstruction aged 42, 51 and 72 months were referred to the authors. Their symptoms persisted after probing twice with or without infracture inferior turbinate. The authors decided to insert a silicone tubing by using an 18-gauge, intravascular catheter as a channel to place a silicone tubing into the nasolacrimal system. Success was defined as a complete resolution of symptoms and signs (tearing, crusting, discharge, regurgitation on pressure over the lacrimal sac) after silicone intubation.
All three patients were free of symptoms and signs after insertion of silicone tubing and an average 5.5 months (9, 6, 1.5 months) after removal of the silicone tubing. There were no intraoperative complications. No unplanned silicone tubing removal was needed and also no complications associated with silicone stent, such as punctal erosion, corneal erosion or granuloma formation occurred.
This simple and low cost technique using an intravascular catheter as a channel to place the silicone tubing into the nasolacrimal system in case of congenital nasolacrimal duct obstruction in children works well. This new technique is not only inexpensive but also effortless with no complications.
提出一种简单且低成本的技术，即在手术室使用简单材料，用于在儿童探通失败后鼻泪管阻塞时进行硅胶管插管。
该研究为连续病例系列。三名分别为42、51和72个月大的先天性鼻泪管阻塞患儿被转诊至作者处。在进行两次探通（无论是否伴有下鼻甲骨折）后，他们的症状仍持续存在。作者决定使用18号血管内导管作为通道，将硅胶管插入鼻泪系统。成功定义为硅胶管插管后症状和体征（流泪、结痂、分泌物、压迫泪囊时反流）完全消失。
所有三名患者在插入硅胶管后以及平均在拔除硅胶管5.5个月（9、6、1.5个月）后均无症状和体征。术中无并发症。无需意外拔除硅胶管，也未发生与硅胶支架相关的并发症，如泪点糜烂、角膜糜烂或肉芽肿形成。
这种使用血管内导管作为通道将硅胶管插入儿童先天性鼻泪管阻塞鼻泪系统的简单且低成本技术效果良好。这项新技术不仅成本低廉，而且操作简便，无并发症。
