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小儿经鼻泪囊鼻腔造口术:116例多中心系列研究

Pediatric endonasal dacryocystorhinostomy: A multicenter series of 116 cases.

作者信息

Chan WengOnn, Wilcsek Geoff, Ghabrial Raf, Goldberg Robert Alan, Dolman Peter, Selva Dinesh, Malhotra Raman

机构信息

a South Australian Institute of Ophthalmology, Royal Adelaide Hospital , Adelaide , Australia.

b Discipline of Ophthalmology & Visual Sciences , University of Adelaide , Adelaide , Australia.

出版信息

Orbit. 2017 Oct;36(5):311-316. doi: 10.1080/01676830.2017.1337168. Epub 2017 Jul 19.

Abstract

We report our experience with pediatric endonasal dacryocystorhinostomy (DCR). Multicenter, retrospective, noncomparative study. Cases of pediatric endonasal DCR during 2006-2011 were included from six oculoplastic units. Patients over the age of 16 years were excluded. The outcomes of pediatric endonasal DCR are presented. Indication for surgery, demographics, previous interventions, intraoperative or postoperative complications, follow-up duration, and success rate (defined as significant improvement of epiphora) were evaluated. In total, 116 endonasal DCRs were performed for 103 patients. The mean follow-up period was 8 months (range 3 months to 4 years), with 1 patient lost to follow-up. There were 48 males (mean age 5 years and 9 months) and 50 females (range of 4 months to 16 years), with a total of 98 cases of congenital nasolacrimal duct obstruction (CNLDO) (84.5%) and 18 cases of acquired nasolacrimal duct obstruction (ANLDO) (15.5%). Previous interventions included probing 75.9% (88/116), massaging 43.1% (50/116), and intubation 39.7% (46/116). There were no intraoperative complications. There was one case of postoperative pyogenic granuloma. There were no cases of postoperative infection and postoperative hemorrhage. Ninety percent of procedures were considered successful. Complete symptom resolution was observed in 78% (90/116), significant improvement in 12% (14/116), partial improvement in 2% (2/116), and no improvement in 8% (9/116). In our series, we demonstrated that endonasal DCR is a safe operation and has an overall success rate of 90% for pediatric NLDO.

摘要

我们报告了小儿鼻内镜下泪囊鼻腔造口术(DCR)的经验。多中心、回顾性、非对照研究。纳入了2006年至2011年间六个眼整形科室的小儿鼻内镜下DCR病例。排除16岁以上的患者。呈现了小儿鼻内镜下DCR的结果。评估了手术指征、人口统计学资料、既往干预措施、术中或术后并发症、随访时间以及成功率(定义为泪溢症状显著改善)。共对103例患者实施了116次鼻内镜下DCR。平均随访期为8个月(范围3个月至4年),1例患者失访。男性48例(平均年龄5岁9个月),女性50例(年龄范围4个月至16岁),其中先天性鼻泪管阻塞(CNLDO)98例(84.5%),后天性鼻泪管阻塞(ANLDO)18例(15.5%)。既往干预措施包括探通术75.9%(88/116)、按摩43.1%(50/116)和插管39.7%(46/116)。术中无并发症。术后有1例化脓性肉芽肿。无术后感染和术后出血病例。90%的手术被认为成功。78%(90/116)的患者症状完全缓解,12%(14/116)显著改善,2%(2/116)部分改善,8%(9/116)无改善。在我们的系列研究中,我们证明鼻内镜下DCR是一种安全的手术,对于小儿鼻泪管阻塞总体成功率为90%。

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