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放射性碘甲状腺消融术后的内镜下泪囊鼻腔造口术

Endoscopic dacryocystorhinostomy following radioactive iodine thyroid ablation.

作者信息

Van Tassel Sarah H, Segal Kira L, Hsu Nicole M, Kacker Ashutosh, Lelli Gary J

机构信息

a Department of Ophthalmology , New York Presbyterian Hospital - Weill Cornell Medical College , New York , New York , USA.

b Department of Otolaryngology - Head and Neck Surgery Group , United States Air Force Academy , Colorado Springs , Colorado , USA.

出版信息

Orbit. 2017 Apr;36(2):59-63. doi: 10.1080/01676830.2017.1279653. Epub 2017 Feb 28.

Abstract

This article evaluates the efficacy of endoscopic dacryocystorhinostomy (eDCR) for nasolacrimal duct obstruction (NLDO) in patients exposed to radioactive iodine (RAI) for treatment of thyroid carcinoma. Retrospective chart review of 7 eDCR procedures was performed on 6 patients, aged 18 or older, with prior RAI treatment, who underwent eDCR between January 1, 2008 and December 31, 2013 for treatment of epiphora due to NLDO. Average time to tube removal was 159 days, and average follow-up was 341 days. One patient noted complete epiphora relief at the time of their final visit. Partial symptom relief was noted by 3 patients, and recurrent epiphora was noted by 2 patients. In complex patients with RAI-associated NLDO, eDCR may be a reasonable option for relief of epiphora. Appropriate counseling, including the risks of incomplete symptom relief and need for additional surgery, should be discussed pre-operatively with these patients.

摘要

本文评估了内镜下泪囊鼻腔造口术(eDCR)对因接受放射性碘(RAI)治疗甲状腺癌而出现鼻泪管阻塞(NLDO)的患者的疗效。对6例年龄在18岁及以上、曾接受RAI治疗、于2008年1月1日至2013年12月31日期间因NLDO导致溢泪而接受eDCR手术的患者进行了7次eDCR手术的回顾性病历审查。拔管平均时间为159天,平均随访时间为341天。1例患者在最后一次就诊时溢泪完全缓解。3例患者症状部分缓解,2例患者出现复发性溢泪。对于患有RAI相关NLDO的复杂患者,eDCR可能是缓解溢泪的合理选择。术前应与这些患者讨论适当的咨询内容,包括症状缓解不完全的风险和额外手术的必要性。

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