Bink A, Lüchtenberg M, Berkefeld J
Institut für Neuroradiologie, Goethe-Universität Frankfurt a.M., Schleusenweg 2-16, Haus 95, 60528 Frankfurt a.M.
Radiologe. 2008 Dec;48(12):1155-60. doi: 10.1007/s00117-008-1695-9.
Epiphora (continuous watering of the eyes) is frequently caused by obstruction of the lacrimal draining system. Radiographic imaging of the tear ducts after contrast injection with the DSA (digital subtraction angiography) dacryocystography technique is still the gold standard in patients with severe epiphora which does not respond to conservative therapy. Recent techniques, such as 3D rotational dacryocystography, MRI and CT are able to show the anatomic surroundings in addition to the ductal structures and are especially useful for planning endoscopic operations. Dacryocystographically assisted interventions, such as balloon dilatation or stenting of tear duct stenoses are technically feasible. Balloon dacryocystoplasty is especially successful in patients with incomplete or short distance obstructions of the nasolacrimal duct. Stenting may improve procedural success and patency rates. Minimally invasive interventional therapy is useful as an initial treatment in selected cases, however, long-term success rates may be limited and operative dacryocystorhinostomy still plays an important role. Comparative studies for evaluation of different therapeutic options are necessary.
溢泪（眼睛持续流泪）通常是由泪液引流系统阻塞引起的。采用数字减影血管造影（DSA）泪囊造影技术在注入造影剂后对泪道进行影像学检查，对于严重溢泪且保守治疗无效的患者仍是金标准。诸如三维旋转泪囊造影、磁共振成像（MRI）和计算机断层扫描（CT）等最新技术，除了能显示导管结构外，还能展示解剖学周围情况，对规划内镜手术尤其有用。泪囊造影辅助干预措施，如泪道狭窄的球囊扩张或支架置入，在技术上是可行的。球囊泪囊成形术在鼻泪管不完全阻塞或阻塞距离短的患者中尤其成功。支架置入可提高手术成功率和通畅率。微创介入治疗在特定病例中作为初始治疗方法是有用的，然而，长期成功率可能有限，手术泪囊鼻腔吻合术仍起着重要作用。有必要进行比较研究以评估不同的治疗选择。
