Division of Ophthalmic Plastic/Reconstructive Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Ophthalmic Plast Reconstr Surg. 2011 Mar-Apr;27(2):87-9. doi: 10.1097/IOP.0b013e3181d09d06.
To describe a stent placement method that eliminates stent prolapse in external dacryocystorhinostomy.
A retrospective, institutional review board- approved case series of patients undergoing external dacryocystorhinostomy with an alternative stenting method. Following anastomosis of the posterior flaps, one arm of a Crawford silicone stent is passed through each canaliculus. Both arms are then passed through the nasolacrimal duct and retrieved in the inferior meatus. The 2 distal arms are redirected in the nose; one arm is looped around the proximal portions within the lacrimal sac and tied to the second arm. The stent is self-linked around the inferior turbinate.
Nine patients underwent external dacryocystorhinostomy with alternative stenting. None experienced postoperative stent prolapse. At last follow-up (average, 38 months; range, 5-102 months), 8 patients reported resolution of tearing and exhibited normal dye clearance. On compression of the lacrimal sac, none of these 8 patients exhibited reflux of stagnant tears or dye through the canaliculi.
This alternative method improves stent retention by using the inferior turbinate as a stopper to eliminate stent prolapse. The self-linking nature obviates the need and expense of additional biomedical devices.
描述一种可防止外置式经鼻泪囊吻合术支架脱出的支架放置方法。
回顾性分析采用替代支架方法行外置式经鼻泪囊吻合术患者的机构审查委员会批准的病例系列。后瓣吻合后，将 Crawford 硅酮支架的一个臂穿过每个泪小管。然后将两个臂穿过鼻泪管并在下鼻道中取出。将两个远端臂重新定向到鼻子中；一个臂围绕泪囊内的近端部分成环并系在第二臂上。支架在下鼻甲周围自行连接。
9 名患者接受了替代性支架外置式经鼻泪囊吻合术，均未发生术后支架脱出。末次随访（平均 38 个月；范围 5-102 个月）时，8 例患者报告流泪症状缓解，且表现出正常的染料清除。对泪囊进行压迫时，这 8 例患者均未出现泪液或染料通过泪小管反流。
该替代方法利用下鼻甲作为塞子，防止支架脱出，从而提高了支架的保持力。其自连接的特性避免了使用额外的生物医学装置的需要和费用。
