Korkut Arzu Yasemin, Teker Aysenur Meric, Yazici Mine Zahide, Kahya Volkan, Gedikli Orhan, Kayhan Fatma Tulin
Department of Otorhinolaryngology, Vakif Gureba Training and Research Hospital, Istanbul, Turkey.
J Craniofac Surg. 2010 Nov;21(6):1706-8. doi: 10.1097/SCS.0b013e3181f3c6c1.
In the current study, whereas the results of endoscopic primary and revision endoscopic dacryocystorhinostomies (END-DCR) were evaluated, the success rates in patients who did or did not undergo nasal surgery were also compared.
A retrospective medical record review of 70 patients (with a total of 72 affected cases) who were admitted to our clinic with a primary complaint of epiphora between January 2002 and July 2009 was performed. Patients who required additional nasal procedures were also included in the analysis. A successful DCR was defined as relief of symptoms on testing with irrigation at the last follow-up visit.
The success rates were 82.1% (23/28 DCRs) in the primary END-DCR group and 84.1% (37/44 DCRs) in the revision END-DCR group. There were no significant differences between the groups regarding overall surgical success rates (P = 0.829). The need for additional nasal surgery was significantly higher in the revision cases (52.3%) than the primary cases (28.6%; P = 0.048). No significant difference regarding success rates existed between the patients who required an additional septoplasty or ancillary sinus surgery and the patients who did not have nasal pathology and underwent END-DCR alone (P = 0.456). The mean follow-up period was 11 months in the revision END-DCR group and 8 months in the primary END-DCR group.
Endoscopic DCR should be considered as the treatment of choice in cases with intranasal pathologies. Endoscopic DCR is a safe and effective procedure in revision cases, as well as in primary cases.
在本研究中,评估了内镜下初次及翻修泪囊鼻腔吻合术(END-DCR)的结果,同时比较了接受或未接受鼻腔手术患者的成功率。
对2002年1月至2009年7月因溢泪为主诉入住我院的70例患者(共72例患侧)进行回顾性病历分析。需要额外鼻腔手术的患者也纳入分析。成功的泪囊鼻腔吻合术定义为在最后一次随访时冲洗测试症状缓解。
初次END-DCR组成功率为82.1%(28例手术中23例成功),翻修END-DCR组成功率为84.1%(44例手术中37例成功)。两组总体手术成功率无显著差异(P = 0.829)。翻修病例中需要额外鼻腔手术的比例(52.3%)显著高于初次病例(28.6%;P = 0.048)。需要额外鼻中隔成形术或辅助鼻窦手术的患者与无鼻腔病变仅接受END-DCR的患者成功率无显著差异(P = 0.456)。翻修END-DCR组平均随访时间为11个月,初次END-DCR组为8个月。
对于有鼻内病变的病例,内镜下泪囊鼻腔吻合术应被视为首选治疗方法。内镜下泪囊鼻腔吻合术在翻修病例以及初次病例中都是一种安全有效的手术。