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改良内镜下鼻腔泪囊吻合术中保留鼻黏膜及泪囊瓣技术。

A Modified Preserved Nasal and Lacrimal Flap Technique in Endoscopic Dacryocystorhinostomy.

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, P.R. China.

Brookdale University Hospital and Medical Center, Brooklyn, NY, 11212, USA.

出版信息

Sci Rep. 2017 Jul 28;7(1):6809. doi: 10.1038/s41598-017-07364-9.

Abstract

Here we describe a modified preserved nasal and lacrimal mucosal flap technique in endonasal endoscopic dacryocystorhinostomy (EES-DCR) for patients with epiphora secondary to primary acquired nasolacrimal duct obstruction (PANDO) and evaluate its outcomes. Twenty-five patients with PANDO were retrospectively reviewed. Modified preserved nasal and lacrimal mucosal flap technique in EES-DCR was applied in all 27 eyes of 25 patients. The patients were evaluated with objective (anatomical patency) and subjective (symptomatic cure) success rates within the duration of follow-up. In the present study, all of the patients' surgical procedures were successful. There were 2 cases of flap dislocation from the rhinostomy site 1 week post-operation. After a mean follow-up of 4.9 ± 1.8 months, the success rate of anatomical patency was 100% (27/27) and the success rate of symptomatic cure was 92.6% (25/27). No significant complications occurred intraoperatively. We concluded that the modified preserved nasal and lacrimal mucosal flap technique in EES-DCR for treating PANDO is simple and safe, can effectively cover the bare bone around the opened sac, and provide a similar or even better clinical outcome compared with other routine treatment techniques used for this condition.

摘要

我们在此描述了一种改良的鼻内和泪囊黏膜保留瓣技术,用于治疗原发性获得性鼻泪管阻塞(PANDO)继发溢泪的鼻内镜下泪囊鼻腔吻合术(EES-DCR),并评估其疗效。回顾性分析了 25 例 PANDO 患者。25 例患者的 27 只眼均采用改良的 EES-DCR 中保留鼻内和泪囊黏膜瓣技术。在随访期间,通过客观(解剖通畅率)和主观(症状治愈率)成功率评估患者的疗效。在本研究中,所有患者的手术均成功。术后 1 周有 2 例出现瓣移位。平均随访 4.9±1.8 个月后,解剖通畅率为 100%(27/27),症状治愈率为 92.6%(25/27)。术中无明显并发症发生。我们得出结论,改良的 EES-DCR 中保留鼻内和泪囊黏膜瓣技术治疗 PANDO 简单、安全,能有效覆盖开放的囊周围的裸露骨面,与其他用于治疗该疾病的常规治疗技术相比,能提供相似甚至更好的临床效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d43/5533767/53902f9f58d4/41598_2017_7364_Fig1_HTML.jpg

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