van Burink M V, Rakhorst H A, van Couwelaar G M, Schmidbauer U
Department of Plastic, Reconstructive and Hand Surgery, Ziekenhuisgroep Twente, Geerdinksweg 141, 7555 DL Hengelo, The Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Ziekenhuisgroep Twente, Geerdinksweg 141, 7555 DL Hengelo, The Netherlands.
J Plast Reconstr Aesthet Surg. 2018 Dec;71(12):1796-1803. doi: 10.1016/j.bjps.2018.07.024. Epub 2018 Aug 3.
Surgical resection of skin tumors in the medial canthal area may damage the lacrimal duct and can result in chronic epiphora. Postoncologic reconstruction of the lacrimal duct has not been studied extensively. The current study discusses the anatomical and functional features of the lacrimal duct. It describes short-term functional outcomes after monocanalicular reconstruction of the lacrimal duct in a case series of 10 patients.
From February 2015 to October 2017, all patients with a postoncological lacrimal duct defect were analyzed to make an anatomical classification. The functional outcomes of patients after monocanalicular reconstruction were measured with the Munk scale up to 3 months after stent removal.
Twelve patients had lacrimal duct defects after Mohs resection. Anatomical characteristics were used to create a clinical classification for lacrimal duct defects. This classification divides the upper (U) and lower (L) proximal lacrimal duct into two sections which can be damaged: the punctum and pars verticalis (1), the canaliculus horizontalis (2), or combined (3). The Common lacrimal duct (C) is the distal part of the lacrimal duct and can also be affected. Ten patients were analyzed after lacrimal duct reconstruction. Three months after stent removal, none of the patients suffered from epiphora.
This article proposes an anatomical classification for lacrimal duct defects in the proximal lacrimal drainage system. The classification can be applied in comparing cases and determining reconstructive strategies after oncologic skin tumor resection. Short-term results are promising for future efforts to reconstruct the lacrimal duct.
在内眦区域切除皮肤肿瘤可能会损伤泪道，导致慢性溢泪。泪道的肿瘤切除术后重建尚未得到广泛研究。本研究探讨泪道的解剖和功能特征。它描述了10例患者泪道单管重建后的短期功能结果。
2015年2月至2017年10月，对所有肿瘤切除术后泪道缺损的患者进行分析，以进行解剖学分类。在拔除支架后长达3个月的时间内，用蒙克量表测量患者单管重建后的功能结果。
12例患者在莫氏切除术后出现泪道缺损。利用解剖特征对泪道缺损进行临床分类。该分类将泪道近端的上部（U）和下部（L）分为两个可能受损的部分：泪点和垂直部（1）、水平泪小管（2）或两者合并（3）。总泪道（C）是泪道的远端部分，也可能受到影响。对10例泪道重建患者进行了分析。拔除支架3个月后，所有患者均无溢泪症状。
本文提出了泪道近端引流系统泪道缺损的解剖学分类。该分类可用于比较病例和确定肿瘤性皮肤肿瘤切除术后的重建策略。泪道重建的短期结果为未来的努力带来了希望。
