Lee Kyung Chul
Department of Otolaryngology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Am J Rhinol. 2008 Mar-Apr;22(2):210-3. doi: 10.2500/ajr.2008.22.3149.
The purpose of this study was to describe the posterior lacrimal sac approach in endoscopic dacryocystorhinostomy (DCR) performed at our institute and report perioperative results achieved with this procedure.
A prospective clinical study was performed of 35 adult patients with nasolacrimal duct obstruction who underwent posterior lacrimal sac approach DCR from March 1998 to May 2005. Follow-up period ranged from 13 to 30 months (average, 17.5 months; SD, 6.8 months). "Surgical success" was defined as complete relief of epiphora and patent surgical ostium on endoscopic assessment.
Surgical success was achieved in 30/35 (85.7%) patients after the primary surgery. Of 5 unsuccessful patients who complained of occasional epiphora, 4 patients had formed stenosis and 1 patient had granulation around the surgical opening, and all had revision surgery. Four of 5 (80.0%) patients achieved surgical success. Thus, including the result of revision surgery, 34/35 (97.1%) patients were successful.
Posterior lacrimal sac approach in endoscopic DCR has several advantages: good sac accessibility, a low complication rate, and a relatively high success rate. Therefore, the posterior lacrimal sac approach appears to offer a useful alternative approach for the surgical treatment of nasolacrimal duct obstruction.
本研究旨在描述我院在内镜下泪囊鼻腔造口术（DCR）中采用的泪囊后入路，并报告该手术的围手术期结果。
对1998年3月至2005年5月期间35例接受泪囊后入路DCR的成年鼻泪管阻塞患者进行了一项前瞻性临床研究。随访期为13至30个月（平均17.5个月；标准差6.8个月）。“手术成功”定义为内镜评估时溢泪完全缓解且手术造口通畅。
初次手术后30/35（85.7%）例患者手术成功。5例手术未成功且抱怨偶尔溢泪的患者中，4例形成狭窄，1例手术开口周围有肉芽组织，所有患者均接受了翻修手术。5例患者中有4例（80.0%）手术成功。因此，包括翻修手术结果在内，34/35（97.1%）例患者手术成功。
内镜下DCR的泪囊后入路有几个优点：泪囊易于暴露、并发症发生率低、成功率相对较高。因此，泪囊后入路似乎为鼻泪管阻塞的手术治疗提供了一种有用的替代方法。
