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鼻内镜下激光泪囊鼻腔造口术的长期效果

Long-term results of endonasal laser dacryocystorhinostomy.

作者信息

Umapathy Neel, Kalra Sukman, Skinner Derek W, Dapling Robert B

机构信息

Department of Otolaryngology, Royal Shrewsbury Hospital, Shrewsbury, United Kingdom.

出版信息

Otolaryngol Head Neck Surg. 2006 Jul;135(1):81-4. doi: 10.1016/j.otohns.2006.02.006.

Abstract

OBJECTIVE

To determine the long-term success rate of endonasal laser dacryocystorhinostomy (DCR) in our unit.

MATERIALS AND METHODS

This was a retrospective study including all the consecutive cases of endonasal laser DCR (ELDCR) between November 1996 and December 1999. Patients who underwent revision DCR were excluded. The absence or improvement of symptoms as reported by the patients was defined as successful outcome. Conversely, recurrence of epiphora was considered as failure. The results were reviewed at 1 year in the clinic and at further 3 years and 5 years by telephone consultation.

RESULTS

There were 65 patients (73 procedures) in the study cohort, with a mean follow-up period of 74 months (range, 60-97). Early failure was noted in 13 patients at 1 year. Only 28 patients (of the possible 50) were free from epiphora after 5 years postsurgery.

CONCLUSION

We found that the success rate of ELDCR has gradually declined over the years to 56% (confidence interval, 38-69) in patients who had at least 5 years of postoperative data. We do not advocate the use of laser in endonasal DCR for patients with epiphora.

EBM RATING

C-4.

摘要

目的

确定我科鼻内镜下激光泪囊鼻腔造口术(DCR)的长期成功率。

材料与方法

这是一项回顾性研究,纳入了1996年11月至1999年12月期间所有连续的鼻内镜下激光DCR(ELDCR)病例。接受过泪囊鼻腔造口术翻修的患者被排除。患者报告的症状消失或改善被定义为成功结果。相反,泪溢复发被视为失败。结果在术后1年于门诊复查,之后在3年和5年通过电话咨询复查。

结果

研究队列中有65例患者(73例手术),平均随访期为74个月(范围60 - 97个月)。13例患者在1年时出现早期失败。术后5年时,仅28例患者(可能的50例中)无泪溢。

结论

我们发现,对于有至少5年术后数据的患者,ELDCR的成功率多年来逐渐下降至56%(置信区间,38 - 69)。我们不主张对泪溢患者使用激光进行鼻内镜下泪囊鼻腔造口术。

循证医学评级

C - 4

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