Bothra Nandini, Naik Milind N, Ali Mohammad Javed
a Govindram Seksaria Institute of Dacryology , L.V. Prasad Eye Institute , Hyderabad , India.
Orbit. 2019 Apr;38(2):107-111. doi: 10.1080/01676830.2018.1477808. Epub 2018 May 22.
The purpose of the article is to report the outcomes of powered endoscopic dacryocystorhinostomy (PEnDCR) in pediatric patients.
A single-center, single surgeon, retrospective, interventional, non-comparative case series was performed on all pediatric patients who underwent PEnDCR between July 2014 and July 2017. Patients with associated congenital anomalies like single punctum agenesis or lacrimal fistula were excluded. Surgery was performed as per standard protocols published earlier. Data collected include demographics, clinical presentations, past interventions, indications for the surgery, intraoperative and postoperative complications, postoperative ostium characteristics, and anatomical and functional success.
Ninety-one eyes of 83 children underwent PEnDCR during the study period. Mean age was 8.32 years and epiphora was the most common presentation (81%, 74/91). The most common indication for PEnDCR was persistent congenital nasolacrimal duct obstruction refractory to earlier interventions of probing or intubation. Postoperative ostium assessment at 4 weeks showed a well-healed ostium with a dynamic internal common opening in 86.8% of the eyes. Edge granulomas of the ostium were the most common abnormal finding in the postoperative period (9.8%, 9/91) and all except one could be managed conservatively. At 6 months follow-up, five eyes showed anatomical failure and additional two eyes showeXd functional failure. Two of anatomical failure group and one of functional failure underwent a second intervention. The final anatomical and functional success were noted in 96.7% (88/91) and 95.6% (87/91), respectively.
This study shows that PEnDCR is a safe surgery for pediatric populations with a high success rate of beyond 95%.
本文旨在报告小儿患者动力性鼻内镜下泪囊鼻腔造口术（PEnDCR）的手术结果。
对2014年7月至2017年7月期间接受PEnDCR手术的所有小儿患者进行了一项单中心、单术者、回顾性、介入性、非对照病例系列研究。排除伴有先天性异常如单个泪点缺如或泪囊瘘的患者。手术按照先前发表的标准方案进行。收集的数据包括人口统计学资料、临床表现、既往干预措施、手术指征、术中及术后并发症、术后造口特征以及解剖学和功能学上的成功情况。
在研究期间，83名儿童的91只眼睛接受了PEnDCR手术。平均年龄为8.32岁，溢泪是最常见的表现（81%，74/91）。PEnDCR最常见的指征是先前的探通或插管干预无效的持续性先天性鼻泪管阻塞。术后4周的造口评估显示，86.8%的眼睛造口愈合良好，内部共同开口动态良好。造口边缘肉芽肿是术后最常见的异常发现（9.8%，9/91），除1例之外其余均可行保守治疗。在6个月的随访中，5只眼睛出现解剖学失败，另外2只眼睛出现功能学失败。解剖学失败组中的2只眼睛和功能学失败组中的1只眼睛接受了二次干预。最终的解剖学和功能学成功率分别为96.7%（88/91）和95.6%（87/91）。
本研究表明，PEnDCR对于小儿患者是一种安全的手术，成功率超过95%。
