Cakmak Sevin Soker, Yildirim Muzeyyen
Department of Ophthalmology, Dicle University Faculty of Medicine, TR-21280 Diyarbakır, Turkey.
Int J Pediatr Otorhinolaryngol. 2010 Nov;74(11):1320-2. doi: 10.1016/j.ijporl.2010.08.015. Epub 2010 Sep 20.
To evaluate the clinical outcome and efficacy of endocanalicular laser dacryocystorhinostomy using a multidiode laser in cases unresponsive to medical therapy, probing or intubation of pediatric nasolacrimal duct obstruction.
Eight children with nasolacrimal duct obstruction were treated with a multidiode laser. The study was prospective, non-randomized, and noncomparative. The patients, 2 (25%) males and 6 (75%) females, ranged in age from 8 to 13 years (mean 11.25±2.43). Surgery was performed under general anesthesia. All procedures were performed using a multidiode laser. The nasal passage was visualized with a 30° nasal video endoscope. In all cases, silicone stents were inserted. The main outcome measure was resolution or improvement of the epiphora and no major laser damage intranasally. Patients were followed for at least 6 months.
The endocanalicular laser dacryocystorhinostomy failed in one of the 8 (12.5%) cases, which had been secondary to trauma. The others were due to primary nasolacrimal duct obstruction. External dacryocystorhinostomy was performed on the failed case. None of the cases with primary nasolacrimal duct obstruction had obstruction after the endocanalicular laser dacryocystorhinostomy operation.
Endocanalicular laser dacryocystorhinostomy using a multidiode laser appears to be an effective technique in cases unresponsive to medical therapy, probing or intubation of primary nasolacrimal duct obstruction.
评估在药物治疗、探通或插管治疗小儿鼻泪管阻塞无效的病例中,使用多二极管激光进行泪道内激光泪囊鼻腔造口术的临床结局和疗效。
对8例鼻泪管阻塞患儿采用多二极管激光治疗。本研究为前瞻性、非随机、非对照研究。患者年龄8至13岁,平均11.25±2.43岁,其中男性2例(25%),女性6例(75%)。手术在全身麻醉下进行。所有操作均使用多二极管激光。用30°鼻视频内窥镜观察鼻腔。所有病例均插入硅胶支架。主要观察指标为溢泪症状缓解或改善,且鼻内无严重激光损伤。对患者进行至少6个月的随访。
8例(12.5%)中有1例泪道内激光泪囊鼻腔造口术失败,该例为外伤继发。其他病例为原发性鼻泪管阻塞。对失败病例进行了外路泪囊鼻腔造口术。原发性鼻泪管阻塞的病例在泪道内激光泪囊鼻腔造口术后均无阻塞。
对于原发性鼻泪管阻塞,在药物治疗、探通或插管治疗无效的病例中,使用多二极管激光进行泪道内激光泪囊鼻腔造口术似乎是一种有效的技术。