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经鼻内窥镜下钬激光泪囊鼻腔吻合术:是否可替代传统的外路泪囊鼻腔吻合术?

Endoscopic transcanalicular diode laser dacryocystorhinostomy: is it an alternative method to conventional external dacryocystorhinostomy?

机构信息

Department of Ophthalmology, Inonu University School of Medicine, Malatya, Turkey.

出版信息

Ophthalmic Plast Reconstr Surg. 2013 Jan-Feb;29(1):15-7. doi: 10.1097/IOP.0b013e31826b76a4.

Abstract

PURPOSE

To compare the success rates of endoscopic transcanalicular diode laser dacryocystorhinostomy (EL-DCR) and external DCR.

MATERIALS AND METHODS

Operations were performed on 55 eyes of 54 patients who had distal nasolacrimal canal obstruction. External DCR was performed on 29 of the eyes and EL-DCR on 26 of them. Success was defined based on subjective relief of patients reported at their final examinations.

RESULTS

There were 23 women and 6 men in group 1 and 19 women and 6 men in group 2 (p = 0.77). The mean ages of groups were 45.24 ± 12.08 (range, 15-74) and 43.2 ± 17.01 (range, 11-72) years, respectively (p = 0.63). The mean follow-up times were 8.82 ± 5.51 (range, 3-18) and 7.12 ± 2.96 (range, 2-12) months, respectively in groups (p = 0.58). The success rates based on symptoms were measured at 25 of 29 (86%) and 17 of 25 (68%) for 2 groups. The difference in the success rates was higher but not found to be statistically significant (p = 0.202). The authors found various conditions related to nasal passage in 4 of 8 unsuccessful EL-DCR, including allergic rhinitis, nasal crust, silicone tube reaction, and unsuitable passage for endoscopic surgery.

CONCLUSIONS

The success rate of EL-DCR was lower than that of the external DCR; however, no statistically significant difference was observed. Endoscopic transcanalicular diode laser DCR may be considered as an alternative method to external DCR with these results.

摘要

目的

比较经鼻内窥镜下钬激光泪囊鼻腔吻合术(EL-DCR)和外路泪囊鼻腔吻合术的成功率。

材料和方法

对 54 例 55 只患有下泪道阻塞的患者进行了手术。其中 29 只眼行外路泪囊鼻腔吻合术,26 只眼行 EL-DCR。根据患者最终检查时的主观缓解情况定义手术成功。

结果

第 1 组有 23 名女性和 6 名男性,第 2 组有 19 名女性和 6 名男性(p = 0.77)。第 1 组的平均年龄为 45.24 ± 12.08 岁(范围 15-74 岁),第 2 组为 43.2 ± 17.01 岁(范围 11-72 岁)(p = 0.63)。第 1 组的平均随访时间为 8.82 ± 5.51 个月(范围 3-18 个月),第 2 组为 7.12 ± 2.96 个月(范围 2-12 个月)(p = 0.58)。根据症状评估,第 1 组的成功率为 29 例中的 25 例(86%),第 2 组为 25 例中的 17 例(68%)。虽然成功率差异较大,但无统计学意义(p = 0.202)。作者发现,在 4 例 EL-DCR 不成功的病例中存在与鼻道相关的各种情况,包括变应性鼻炎、鼻痂、硅胶管反应和不适合内镜手术的通道。

结论

EL-DCR 的成功率低于外路泪囊鼻腔吻合术,但无统计学差异。基于这些结果,EL-DCR 可被视为外路泪囊鼻腔吻合术的替代方法。

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