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慢性泪囊炎的外路和内镜下泪囊鼻腔造孔术:结果比较

External and endoscopic dacryocystorhinostomy in chronic dacryocystitis: comparison of results.

作者信息

Yigit Ozgur, Samancioglu Mehmet, Taskin Umit, Ceylan Serdar, Eltutar Kadir, Yener Murat

机构信息

Otorhinolaryngology Department, Ministry of Health, Istanbul Research and Training Hospital, Istanbul, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2007 Aug;264(8):879-85. doi: 10.1007/s00405-007-0286-0. Epub 2007 Mar 27.

Abstract

To compare external and endoscopic dacryocystorhinostomy outcomes in patients with chronic dacryocystitis, a total of 103 patients with the complaint of epiphora and diagnosed as chronic dacryocystitis were included in the study. We performed external dacryocystorhinostomy on 55 patients under local anesthesia and endoscopic dacryocystorhinostomy on 48 patients under general anesthesia by means of drill and placed silicon stents to all the patients. The patients were examined endoscopically, at postoperative intervals of 1 week, first month, third month, sixth month and the first year. The patency of the tubes and nasolacrimal ducts were evaluated by irrigation and complaints of the patients were noted. Silicon stents were harvested at the sixth week postoperatively. Outcomes were classified as successful when epiphora diminished, no recurrent infection was noted and minimal or no reflux from the canaliculis during or after lacrimal irrigation was seen. A prospective endoscopic surgery group was compared to a prospective control group (external dacryocystorhinostomy). Full success was achieved in 69.9% of the patients with external dacryocystorhinostomy group whereas the full success rate of endoscopic dacryocystorhinostomy was 89.7%. Recently popularized endoscopic dacryocystorhinostomy is a safe and reliable procedure with high success rates.

摘要

为比较慢性泪囊炎患者行外路泪囊鼻腔吻合术与内镜下泪囊鼻腔吻合术的疗效,本研究共纳入103例主诉溢泪且诊断为慢性泪囊炎的患者。我们对55例患者在局部麻醉下行外路泪囊鼻腔吻合术,对48例患者在全身麻醉下通过钻进行内镜下泪囊鼻腔吻合术,并对所有患者置入硅胶支架。术后1周、第1个月、第3个月、第6个月及第1年对患者进行内镜检查。通过冲洗评估泪管和鼻泪管的通畅情况,并记录患者的主诉。术后第6周取出硅胶支架。当溢泪减轻、无复发性感染且泪道冲洗时或冲洗后泪小管反流极少或无反流时,结果判定为成功。将前瞻性内镜手术组与前瞻性对照组(外路泪囊鼻腔吻合术)进行比较。外路泪囊鼻腔吻合术组69.9%的患者获得完全成功,而内镜下泪囊鼻腔吻合术的完全成功率为89.7%。最近推广的内镜下泪囊鼻腔吻合术是一种安全可靠、成功率高的手术。

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