Department of Ophthalmology, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.
Ophthalmic Plast Reconstr Surg. 2013 Jul-Aug;29(4):294-7. doi: 10.1097/IOP.0b013e318295f903.
To describe the technique of endocanalicular laser dacryocystorhinostomy with mucosal flap creation and to report the outcomes of this technique.
Prospective noncomparative case series of 7 patients with primary acquired nasolacrimal duct obstruction undergoing endocanalicular laser dacryocystorhinostomy with mucosal flap. The mucosal flap was created using an endoscopic endonasal approach. An endocanalicular approach was used to fashion the lacrimal sac opening and the osteotomy of the lacrimal sac fossa.
Nine procedures were performed in 7 female patients. Average patient age was 68±15 years. Intraoperative complications included bleeding during the creation of the mucosal flap in 1 patient. The procedure was associated with no pain to moderate pain in all cases. Anatomical success was achieved in 89% of procedures and symptomatic relief was achieved in 89% of surgeries for an average follow up of 10 ± 5 months. Only 1 patient required an external dacryocystorhinostomy revision because of postoperative restenosis.
Endocanalicular laser dacryocystorhinostomy provides a minimally invasive approach to epiphora with a good success rate. The addition of a nasal mucosal flap to this technique may aid in proper fistulization and should be studied in larger prospective trials.
描述经鼻内窥镜下使用黏膜瓣的内路激光泪囊鼻腔吻合术的技术，并报告该技术的结果。
对 7 例原发性获得性鼻泪管阻塞患者进行前瞻性非对照病例系列研究，这些患者均接受经鼻内窥镜下使用黏膜瓣的内路激光泪囊鼻腔吻合术。使用鼻内窥镜内入路创建黏膜瓣。使用经内路的方法来塑造泪囊开口和泪囊窝的截骨术。
7 名女性患者共进行了 9 次手术。平均患者年龄为 68±15 岁。术中并发症包括 1 例患者在创建黏膜瓣时出血。所有病例的手术过程均伴有不同程度的疼痛，术后疼痛为中度。平均随访 10±5 个月后，89%的手术达到解剖成功，89%的手术缓解了症状。仅有 1 例患者因术后再狭窄需要行外路泪囊鼻腔吻合术翻修。
经鼻内窥镜下使用黏膜瓣的内路激光泪囊鼻腔吻合术为溢泪提供了一种微创的治疗方法，成功率较高。该技术中增加鼻腔黏膜瓣可能有助于正确造瘘，应在更大的前瞻性试验中进行研究。
