Wielgosz Romuald, Mroczkowski Edward
Z Kliniki Laryngologicznej Szpitala Kruppa w Essen, Niemcy.
Klin Oczna. 2011;113(10-12):321-5.
The value of a complex endonasal microsurgical treatment of lacrimal duct stenosis.
in a group of 418 patients we performed 455 dacryocystorhinostomy (DCR) including 37 bilaterally. They were 263 females (62.9%) and 155 males (37.1%). Age ranged from 1.5 to 87, mean age 54.3 years. Performance: general anaesthesia with controlled hypothension, semi sitting position of patient and adjustable headrest, operating microscope (300 mm lens). Operative procedure: septum mobilization and anterior ethmoidectomy, dacryocystorhinostomy (DCR).
satisfactory results were obtained in 436 of cases (95.8%), 19 no change (4.2%). Only 18 cases received a prosthesis. There were only 2 complications (0.2) not serious.
endonasal microscopic dacryocystorhinostomy preserves intact bony support and frame of lacrimal ducts and the nasal function of the lacrimal pump. It allows simultaneous management of the concomitant sino-nasal pathology as well as shorter operation times, lower complication rates and reduced patient morbidity.
探讨鼻内镜下复杂显微手术治疗泪道狭窄的价值。
对418例患者实施了455例泪囊鼻腔吻合术（DCR），其中双侧手术37例。患者中女性263例（62.9%），男性155例（37.1%）。年龄范围为1.5岁至87岁，平均年龄54.3岁。手术操作：全身麻醉并控制性降压，患者半坐位并使用可调节头架，配备300mm镜头的手术显微镜。手术步骤：鼻中隔松动及前筛窦切除术，泪囊鼻腔吻合术（DCR）。
436例（95.8%）取得满意效果，19例（4.2%）无变化。仅18例植入了假体。仅2例（0.2%）出现不严重的并发症。
鼻内镜下显微泪囊鼻腔吻合术可保留泪道完整的骨质支撑和框架以及泪泵的鼻腔功能。它能够同时处理伴发的鼻旁窦病变，且手术时间更短、并发症发生率更低、患者发病率降低。
