Department of Otorhinolaryngology, Institute of Clinical Medicine, Kuopio University Hospital, and University of Eastern Finland, Finland.
Rhinology. 2010 Dec;48(4):446-51. doi: 10.4193/Rhino10.069.
The incidence of nasolacrimal pathway obstruction increases with age, and dacryocystorhinostomy (DCR) is a commonly applied surgical technique to treat severe cases. However, no disease-specific tools to assess the symptoms and the subjective outcome after DCR have been established. We have developed a specific Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS) questionnaire to evaluate the outcome, and tested it in a prospective clinical trial.
Prospective clinical follow-up study.
Sixty-eight consecutive primary endoscopic dacryocystorhinostomy (EN-DCR) procedures were performed in 64 patients during 2004-2008. Preoperatively and during the three follow-up visits (at 1 week, 2 and 6 months), the patients filled in the NLDO-SS, and at the second and third follow-up visits they also filled in the Glasgow Benefit Inventory (GBI) questionnaire. At one year after the operation, a GBI questionnaire was sent to the patients.
The surgical success rate of EN-DCR was 93 %. EN-DCR resulted in a significant reduction in all of the eight symptoms scores of the NLDO-SS (p= 0.001). The GBI scores indicated a significant benefit at 2 months (+37 (SD; 28) and an even higher benefit at 6 months after surgery (+52 (SD; 29), p= 0.001), but no further improvement was found between 6 and 12 months (+52 vs +52, p= 1.0). The correlation between the total GBI and NLDO-SS was significant (p=0.001).
EN-DCR significantly improves the quality of life as measured by the GBI. The NLDO-SS correlated with the GBI and gave more information about the benefits after EN-DCR than GBI alone. The NLDO-SS proved to be an effective tool to evaluate lacrimal obstructions and EN-DCR benefits. Further studies to validate NLDO-SS are needed.
鼻泪管阻塞的发病率随年龄增长而增加，而经鼻内窥镜泪囊鼻腔吻合术（DCR）是治疗严重病例的常用手术方法。然而，目前尚无专门用于评估 DCR 后症状和主观疗效的疾病特异性工具。我们已经开发了一种专门的鼻泪管阻塞症状评分（NLDO-SS）问卷来评估疗效，并在一项前瞻性临床试验中进行了测试。
前瞻性临床随访研究。
2004 年至 2008 年期间，对 64 例患者的 68 例原发性内镜下泪囊鼻腔吻合术（EN-DCR）进行了前瞻性临床随访研究。在术前和第 1 周、2 个月和 6 个月的 3 次随访期间，患者填写 NLDO-SS 问卷，在第 2 次和第 3 次随访时还填写格拉斯哥效益量表（GBI）问卷。术后 1 年，向患者发送 GBI 问卷。
EN-DCR 的手术成功率为 93%。EN-DCR 显著降低了 NLDO-SS 的所有 8 项症状评分（p=0.001）。GBI 评分在术后 2 个月时显著提高（+37（SD；28），术后 6 个月时甚至更高（+52（SD；29），p=0.001），但在 6 至 12 个月之间没有进一步改善（+52 vs +52，p=1.0）。GBI 总分与 NLDO-SS 之间存在显著相关性（p=0.001）。
EN-DCR 显著提高了 GBI 测量的生活质量。NLDO-SS 与 GBI 相关，与单独使用 GBI 相比，能提供更多关于 EN-DCR 后获益的信息。NLDO-SS 被证明是一种评估泪道阻塞和 EN-DCR 获益的有效工具。需要进一步研究来验证 NLDO-SS。
