Department of Otorhinolaryngology, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy.
Eur Arch Otorhinolaryngol. 2009 Nov;266(11):1747-52. doi: 10.1007/s00405-009-1002-z. Epub 2009 Jun 5.
Endoscopic dacryocystorhinostomy (DCR) is a well-established alternative to external approaches in the treatment of nasolacrimal canal obstruction. From July 2004 to December 2008, 92 endoscopic DCRs were performed on 88 patients at the Department of Otorhinolaryngology, San Raffaele Hospital, Milan. All patients were affected by chronic dacryocystitis with epiphora. Preoperative work-up included Jones tests, lacrimal pathways irrigation, nasal endoscopy, and imaging evaluation by computed tomography. The technique involved anastomosis of nasal mucosal, lacrimal sac flaps and a large bony ostium. A silicone tube was inserted in all patients that remained for a period of 3 months. The first endoscopic intervention was successful in 91.30% of patients. After a second revision endoscopic DCR, the overall success rate raised to 95.65%. Anastomosis of nasal mucosal between lacrimal sac flaps plays a key role in endoscopic DCR with a high success rate both in primary nasolacrimal obstructions and in revision cases.
经鼻内镜下泪囊鼻腔吻合术（DCR）是治疗鼻泪管阻塞的一种成熟的替代方法，优于外路手术。2004 年 7 月至 2008 年 12 月，米兰圣拉斐尔医院耳鼻喉科对 88 例患者实施了 92 例经鼻内镜下 DCR。所有患者均患有慢性泪囊炎伴溢泪。术前检查包括 Jones 试验、泪道冲洗、鼻内镜检查和计算机断层扫描影像学评估。该技术包括鼻黏膜、泪囊瓣和大骨造口吻合。所有患者均插入硅胶管，留置 3 个月。91.30%的患者首次内镜干预成功。第二次经内镜 DCR 修正后，总成功率提高至 95.65%。泪囊瓣之间的鼻黏膜吻合在经鼻内镜下 DCR 中起着关键作用，无论是在原发性鼻泪管阻塞还是在修正病例中，成功率都很高。
