Yazici Bulent, Sabur Huri, Orucov Nesimi
Department of Ophthalmology, Uludag University, Bursa, Turkey.
Ophthalmic Plast Reconstr Surg. 2016 Mar-Apr;32(2):116-7. doi: 10.1097/IOP.0000000000000439.
To evaluate whether the use of a direct otoscope in the nose is an effective method to observe the nasolacrimal anastomosis site after dacryocystorhinostomy.
In 75 eyes undergoing external dacryocystorhinostomy, the lacrimal irrigation test was performed and fluorescein solution was instilled in the conjunctival sac. After applying topical anesthetics and decongestant, a direct otoscope was inserted in the middle meatus and directed toward the medial canthus.
In 69 eyes (92%), intranasal lacrimal examination with the otoscope could be performed. In 6 eyes (8%), the otoscope could not be adequately advanced in the nose because of middle meatal stenosis (n = 5 eyes) or intolerance to the intranasal examination (n = 1). In 66 (96%) of 69 eyes, concordant with the results of the lacrimal irrigation test, the presence or absence of fluorescein dye flow in the nose was observed. In this examination, the main features that were useful in locating the anastomotic area were (1) the use of fluorescein dye, (2) motility of the nasal mucosa that was synchronized with eyelid movements, (3) appearance of mucosal hole or internal orifice in the nasal wall, and (4) dye or air-fluid bubble emergence upon blinking or finger pressure over the sac region.
Direct otoscope can be effectively used in the nose for examining the nasolacrimal anastomosis in patients undergoing dacryocystorhinostomy.
评估使用直接检耳镜观察鼻泪管吻合术术后鼻泪管吻合部位是否为一种有效的方法。
对75只接受外路鼻泪管吻合术的眼睛进行泪道冲洗试验，并将荧光素溶液滴入结膜囊。在局部应用麻醉剂和减充血剂后，将直接检耳镜插入中鼻道并指向内眦。
69只眼睛（92%）可以使用检耳镜进行鼻内泪道检查。6只眼睛（8%）因中鼻道狭窄（5只眼睛）或无法耐受鼻内检查（1只眼睛）而无法将检耳镜充分插入鼻腔。在69只眼睛中的66只（96%）中，观察到鼻腔内荧光素染料流动情况与泪道冲洗试验结果一致。在这项检查中，有助于定位吻合区域的主要特征为：（1）使用荧光素染料；（2）鼻黏膜运动与眼睑运动同步；（3）鼻壁出现黏膜孔或内口；（4）在泪囊区域眨眼或手指按压时出现染料或气液泡。
直接检耳镜可有效地用于鼻腔检查接受鼻泪管吻合术患者的鼻泪管吻合情况。
