Tsirbas Angelo, Davis Garry, Wormald Peter J
Department of Ophthalmology, Flinders Medical Center, Queen Elizabeth Hospital Adelaide, South Australia.
Am J Rhinol. 2005 May-Jun;19(3):322-5.
Success rates for revision dacryocystorhinostomy (DCR) are lower than primary DCR. Scarring of the sac may limit the ability of the surgeon to achieve good nasal and lacrimal mucosa apposition. This study evaluates the comparative success rates of the external and endoscopic techniques for revision DCR.
Seventeen consecutive revision endoscopic DCRs (average age, 60.9 years) and 13 revision external DCRs (average age, 65.1 years) performed from January 1999 to December 2000 performed by separate surgeons were entered into the study. Patients with functional nasolacrimal and canalicular obstruction were excluded. The average follow-up was 11.1 months for the endoscopic DCR group and 10 months for the external DCR group.
A successful DCR required complete relief of symptoms and an endoscopically determined anatomic patency of the nasolacrimal system. Revision endoscopic DCR surgery was successful in 76.5% of cases (13 of 17 cases) and external DCR surgery was successful in 84.6% (11 of 13 cases). This difference was not statistically significant. (p = 0.64, Fisher exact test with a two-tailed probability).
Revision endoscopic DCR has a success rate of 76.5%, which compares favorably with that of the revision external DCR (84.6%).
泪囊鼻腔吻合术（DCR）翻修术的成功率低于初次DCR。泪囊瘢痕形成可能会限制外科医生实现良好的鼻腔和泪道黏膜贴合的能力。本研究评估了内镜技术和外路技术用于DCR翻修术的比较成功率。
1999年1月至2000年12月期间，由不同外科医生分别进行的17例连续性内镜DCR翻修术（平均年龄60.9岁）和13例外路DCR翻修术（平均年龄65.1岁）纳入本研究。排除功能性鼻泪管和泪小管阻塞患者。内镜DCR组平均随访11.1个月，外路DCR组平均随访10个月。
成功的DCR需要症状完全缓解且经内镜确定鼻泪系统解剖通畅。内镜DCR翻修术76.5%的病例（17例中的13例）成功，外路DCR手术84.6%（13例中的11例）成功。这种差异无统计学意义（p = 0.64，双侧概率的Fisher精确检验）。
内镜DCR翻修术成功率为76.5%，与外路DCR翻修术（84.6%）相比具有优势。
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