Ramakrishnan Vijay R, Hink Eric M, Durairaj Vikram D, Kingdom Todd T
Department of Otolaryngology-Head and Neck Surgery, University of Colorado Health Sciences Center, Denver, Colorado, USA.
Am J Rhinol. 2007 Nov-Dec;21(6):753-7. doi: 10.2500/ajr.2007.21.3095.
The purpose of this study was to evaluate outcomes of powered endoscopic dacryocystorhinostomy (DCR) without the preservation of mucosal flaps for the management of acquired nasolacrimal duct obstruction.
A retrospective review was performed of patients undergoing endoscopic DCR without mucosal flap preservation from May 2003 to October 2006 at a tertiary referral medical center. Twenty-seven procedures were performed on 20 patients with epiphora secondary to acquired nasolacrimal duct obstruction. Main outcome measures were subjective improvement in epiphora and assessment of anatomic patency based on lacrimal irrigation.
Mean follow-up was 16 months. Mild intermittent postoperative epiphora or complete resolution of epiphora was noted in 100% (27/27) of procedures; complete resolution was recorded in 93% (25/27) of procedures. Eighteen patients (25 procedures) were available for lacrimal irrigation at a mean of 16 months follow-up. Anatomic patency was confirmed in 100% (25/25) of procedures.
Our results with endoscopic DCR are comparable with previously published outcomes. These data suggest that successfully powered DCR may be performed without the preservation of mucosal flaps.
本研究旨在评估不保留黏膜瓣的动力性鼻内镜下泪囊鼻腔造口术（DCR）治疗后天性鼻泪管阻塞的效果。
对2003年5月至2006年10月在一家三级转诊医疗中心接受不保留黏膜瓣的内镜下DCR手术的患者进行回顾性研究。对20例因后天性鼻泪管阻塞导致溢泪的患者进行了27次手术。主要观察指标为溢泪症状的主观改善情况以及基于泪道冲洗的解剖学通畅性评估。
平均随访时间为16个月。100%（27/27）的手术出现轻度间歇性术后溢泪或溢泪完全缓解；93%（25/27）的手术记录为溢泪完全缓解。18例患者（25次手术）在平均随访16个月时可进行泪道冲洗。100%（25/25）的手术证实解剖学通畅。
我们的内镜下DCR手术结果与先前发表的结果相当。这些数据表明，成功的动力性DCR手术可以在不保留黏膜瓣的情况下进行。
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