Bayraktar Cem, Şimşek Ali
*Department of Otolaryngology Head and Neck Surgery †Department of Ophthalmology, Adiyaman University Research and Education Hospital, Adiyaman, Turkey.
J Craniofac Surg. 2017 Jun;28(4):980-982. doi: 10.1097/SCS.0000000000003502.
The etiology of primary nasolacrimal duct obstruction (NLDO) is unknown, and the disease may exist bilaterally in a small number of patients. Dacryocystorhinostomy (DCR) surgery is the recommended treatment for these patients, but concomitant nasal pathologies are believed to be related to decreased surgical success. The authors aim to assess the concomitant required nasal surgical procedure frequency for endoscopic surgical access retrospectively in bilateral and unilateral NLDO patients. Twenty-eight patients who underwent bilateral endoscopic DCR simultaneously and 30 patients who underwent unilateral endoscopic DCR were enrolled in this retrospective study. Required concomitant nasal procedure frequency was recorded. In the bilaterally applied DCR group, septoplasty, partial midline turbinectomy, and inferior nasal concha submucosal resection rates were 16 (57.1%), 5 (17.8%), and 3 (10.7%) patients, respectively. Septoplasty and concha bullosa resection were performed simultaneously in 2 patients. Also, uncinectomy was performed with septoplasty in 1 patient. The concomitant nasal surgery rate was 22 of 28 patients (78.6%). On the other hand, in the unilaterally applied DCR group, septoplasty, partial midline turbinectomy, and inferior nasal concha submucosal resection rates were 5 (16.7%), 1 (3.3%), and 2 (6.7%) patients, respectively. Both septoplasty and concha bullosa resection were done in 1 patient. Uncinectomy was performed on 1 (3.3%) patient. A concomitant surgery rate was observed in 8 of 30 patients (26.7%). Nasal pathology, which requires surgical intervention, is seen much more frequently in bilateral than in unilateral NLDO patients.
原发性鼻泪管阻塞（NLDO）的病因尚不清楚，少数患者可能双侧患病。泪囊鼻腔吻合术（DCR）是这些患者的推荐治疗方法，但人们认为伴随的鼻腔病变与手术成功率降低有关。作者旨在回顾性评估双侧和单侧NLDO患者在内镜手术入路时所需的同期鼻腔手术频率。本回顾性研究纳入了28例同时接受双侧内镜DCR的患者和30例接受单侧内镜DCR的患者。记录所需的同期鼻腔手术频率。在双侧应用DCR的组中，鼻中隔成形术、部分中线鼻甲切除术和下鼻甲黏膜下切除术的患者分别为16例（57.1%）、5例（17.8%）和3例（10.7%）。2例患者同时进行了鼻中隔成形术和泡状鼻甲切除术。此外，1例患者在鼻中隔成形术时进行了钩突切除术。28例患者中有22例（78.6%）进行了同期鼻腔手术。另一方面，在单侧应用DCR的组中，鼻中隔成形术、部分中线鼻甲切除术和下鼻甲黏膜下切除术的患者分别为5例（16.7%）、1例（3.3%）和2例（6.7%）。1例患者同时进行了鼻中隔成形术和泡状鼻甲切除术。1例（3.3%）患者进行了钩突切除术。30例患者中有8例（26.7%）进行了同期手术。需要手术干预的鼻腔病变在双侧NLDO患者中比在单侧NLDO患者中更常见。
