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[泪器系统裂伤及其手术修复]

[Lacrimal system lacerations and their surgical repair].

作者信息

Struck H G

机构信息

Universitäts-Augenklinik, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland.

出版信息

Ophthalmologe. 2009 Mar;106(3):223-8. doi: 10.1007/s00347-008-1906-9.

Abstract

In lacrimal system lacerations the canaliculi are involved in 70% of cases and the lacrimal sac and/or nasolacrimal duct in 30%. Lacrimal system lacerations can be the result of sharp or blunt trauma. Nasolacrimal ducts may become obstructed by indirect trauma as an aftereffect of naso-orbital fractures. The epidemiology, main principles of surgical repair of canaliculi and of lacrimal sacs and/or nasolacrimal ducts, special techniques of surgical reconstruction and approximate success rates are reviewed with respect to the outcome of our patient collective compared to the literature. Canalicular and lacrimal sac lacerations need urgent primary microsurgical repair with silicone intubation and paying special attention to the medial nasal canthus. In cases of traumatic nasolacrimal duct obstruction as an aftereffect of mid-facial fractures, a secondary reconstruction should be planned.

摘要

在泪器系统撕裂伤中,70%的病例累及泪小管,30%累及泪囊和/或鼻泪管。泪器系统撕裂伤可能由锐器伤或钝器伤导致。鼻泪管可能因鼻眶骨折的间接创伤而受阻。本文结合我们患者群体的治疗结果与文献,综述了泪小管、泪囊和/或鼻泪管手术修复的流行病学、主要原则、手术重建的特殊技术及大致成功率。泪小管和泪囊撕裂伤需要紧急进行一期显微手术修复,并植入硅胶管,同时要特别注意鼻内侧眦部。对于面中部骨折后遗症导致的外伤性鼻泪管阻塞病例,应计划进行二期重建。

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