Ari Seyhmus, Kürşat Cingü Abdullah, Sahin Alparslan, Gün Ramazan, Kiniş Vefa, Caça Ihsan
Department of Ophthalmology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.
Int J Ophthalmol. 2012;5(2):238-41. doi: 10.3980/j.issn.2222-3959.2012.02.24. Epub 2012 Apr 18.
To evaluate the long-term treatment outcomes in patients who underwent revision of external dacryocystorhinostomy (DCR) and nasal intubation by bicanalicular silicone tubing (BSTI) under endonasal endoscopic guidance.
Data from 28 patients with recurrent dacryocystitis were retrospectively reviewed. Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance was performed in 28 eyes of 28 patients. The patients were evaluated with respect to the reason of recurrence, time to recurrence, time to revision, duration of follow-up and surgical success.
Endoscopic endonasal examination detected an osteotomy-side obstruction by the excessive granulation tissue in 24 patients (86%), nasal septal deviation in three patients (10%) and nasal polyp in one patient (4%). Recurrence occurred after a mean duration of 5.3±3.7 months following the first operation. The mean time between the first DCR operation and the revision DCR was 11.5 ± 9.3 months. After a mean follow-up of 14.9±7.8 months, the rate of anatomic success alone was 85% (24/28); the rate of subjective success was 78% (22/28).
Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance can be recommended in patients with recurrent dacryocystitis as a surgical approach that achieves satisfactory objective and subjective success rates.
评估在鼻内镜引导下接受外路泪囊鼻腔吻合术(DCR)翻修及双泪小管硅胶管插管术(BSTI)的患者的长期治疗效果。
回顾性分析28例复发性泪囊炎患者的数据。对28例患者的28只眼在鼻内镜引导下进行外路DCR翻修及双泪小管硅胶管插管术。对患者的复发原因、复发时间、翻修时间、随访时间及手术成功率进行评估。
鼻内镜检查发现,24例患者(86%)因肉芽组织过度增生导致截骨侧阻塞,3例患者(10%)存在鼻中隔偏曲,1例患者(4%)有鼻息肉。首次手术后平均5.3±3.7个月出现复发。首次DCR手术与翻修DCR之间的平均时间为11.5±9.3个月。平均随访14.9±7.8个月后,单纯解剖学成功率为85%(24/28);主观成功率为78%(22/28)。
对于复发性泪囊炎患者,可推荐在鼻内镜引导下进行外路DCR翻修及双泪小管硅胶管插管术,该手术方法可取得令人满意的客观和主观成功率。