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使用单支架和迷你莫诺卡进行泪小管撕裂的显微外科重建。

Microsurgical reconstruction for canalicular laceration using Monostent and Mini-Monoka.

作者信息

Eo SuRak, Park JiUng, Cho SangHun, Azari Kodi K

机构信息

Department of Plastic and Reconstructive Surgery, DongGuk University International Hospital, Ilsan, South Korea.

出版信息

Ann Plast Surg. 2010 Apr;64(4):421-7. doi: 10.1097/SAP.0b013e3181b143a9.

Abstract

Many surgical techniques are available for repairing a lacerated canaliculus, such as, Worst pigtail probing, and monocanalicular or bicanalicular procedures involving silicone intubation. Despite this, controversy still exists regarding the best surgical method in terms of subjective and objective outcomes. We report the experience of microscopic canalicular repair using monocanalicular stents; Monostent (Eagle Vision Inc., Memphis, TN) and Mini-Monoka stents (FCI Ophthalmics, Marshfield Hills, MA) and compare these 2 products. Seventeen cases of canalicular lacerations in 15 consecutive patients underwent microscopic canalicular repair using a monocanalicular procedure with either a Monostent (Eagle Vision Inc.) (5 cases) or a Mini-Monoka stent (FCI Ophthalmics) (12 cases). Microscopic anastomosis of the canalicular mucosa was performed following the placement of a juxta canalicular suture to reduce tension. Subjective and objective flows of repaired lacrimal drainage systems were checked by saline injection using a Healon needle (Advanced Medical Optics, Inc., Santa Ana, CA) and dacryocystogram. Patent lacrimal drainage systems were achieved in 16 of the 17 cases, and mild epiphora was acceptable in 14 patients during follow-up. No cases of spontaneous punctal plug migration, stent displacement, eyeball irritation or inflammation, or granuloma formation were encountered. However, in one case, a Mini-Monoka stent (FCI Ophthalmics) was repeatedly extruded or clogged internally and replaced by Monostent (Eagle Vision Inc.). Although the latter had a larger conduit diameter, it was more flexible and had potentially folded on itself in the lacrimal sac, thus, obstructing flow in this case. Microscopic canalicular reconstruction using a Monostent (Eagle Vision Inc.) or Mini-Monoka stent (FCI Ophthalmics) offers a safe, effective, and straightforward means of acute lacrimal system injury treatment.

摘要

有多种手术技术可用于修复断裂的泪小管,例如Worst猪尾探针探查,以及涉及硅胶插管的单泪小管或双泪小管手术。尽管如此,就主观和客观结果而言,关于最佳手术方法仍存在争议。我们报告了使用单泪小管支架进行显微泪小管修复的经验;Monostent(鹰视公司,田纳西州孟菲斯)和Mini-Monoka支架(FCI眼科公司,马萨诸塞州马什菲尔德山),并比较这两种产品。15例连续患者中的17例泪小管断裂病例接受了使用单泪小管手术的显微泪小管修复,其中5例使用Monostent(鹰视公司),12例使用Mini-Monoka支架(FCI眼科公司)。在放置泪小管旁缝线以减轻张力后,对泪小管黏膜进行显微吻合。使用Healon针(先进医学光学公司,加利福尼亚州圣安娜)注射盐水并进行泪囊造影,检查修复后的泪道引流系统的主观和客观通畅情况。17例中有16例实现了泪道引流系统通畅,随访期间14例患者的轻度溢泪情况可接受。未遇到自发性泪点塞移位、支架移位、眼球刺激或炎症或肉芽肿形成的病例。然而,有1例中,Mini-Monoka支架(FCI眼科公司)反复向外挤出或内部堵塞,随后更换为Monostent(鹰视公司)。尽管后者的导管直径较大,但更具柔韧性,在泪囊中可能自行折叠,从而在该病例中阻碍了引流。使用Monostent(鹰视公司)或Mini-Monoka支架(FCI眼科公司)进行显微泪小管重建为急性泪道系统损伤治疗提供了一种安全、有效且直接的方法。

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