Nacaroglu Senay Asik, Ogreden Sahin, Yılmaz Ahu, Atalay Kursat, Kırgız Ahmet
Department of Ophthalmology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey.
Department of Otolaryngology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey.
Wideochir Inne Tech Maloinwazyjne. 2018 Sep;13(3):401-406. doi: 10.5114/wiitm.2018.77054. Epub 2018 Jul 10.
Transcanalicular laser DCR (TL-DCR) approaches have been developed for the formation of a fistula between the nasal cavity and the lacrimal sac to ensure the continuity of the lacrimal drainage system over the years. However, the success rate of TL-DCR has varied widely.
To evaluate and compare the success rates of conventional transcanalicular multidiode laser dacryocystorhinostomy and modified transcanalicular multidiode laser dacryocystorhinostomy.
Ninety-one eyes of 91 adult patients admitted with epiphora and diagnosed with chronic dacryocystitis were included in the study. The participants were divided into two groups. Group 1 consisted of 55 patients who were treated with conventional transcanalicular laser dacryocystorhinostomy. Group 2 consisted of 36 patients to whom the same surgical procedure was applied with the difference of nasal mucosa excision prior to laser osteotomy. The groups' intraoperative surgical ostium size, perioperative and postoperative complications, operative times and success rates were compared.
The mean follow-up periods for each group were 8.88 ±2.99 months and 10.28 ±4.47 months, respectively (p = 0.077). Intraoperative mean surgical ostium sizes were 31.85 ±14.98 mm and 42.25 ±18.09 mm, respectively (p = 0.004). The mean operation time in group 1 was significantly shorter compared to group 2 (18.55 ±4.05 min and 24.44 ±3.18 min, respectively, p = 0.0001). The overall success rate was 65.45% in group 1 and 75.00% in group 2 (p = 0.335).
Although the surgical ostium area was significantly greater in group 2, there was no significant difference in surgical success and patient satisfaction rates between the two groups.
多年来，经泪小管激光泪囊鼻腔造口术（TL-DCR）已被用于在鼻腔和泪囊之间形成瘘管，以确保泪道引流系统的连续性。然而，TL-DCR的成功率差异很大。
评估并比较传统经泪小管多二极管激光泪囊鼻腔造口术和改良经泪小管多二极管激光泪囊鼻腔造口术的成功率。
本研究纳入了91例因溢泪入院并被诊断为慢性泪囊炎的成年患者的91只眼睛。参与者被分为两组。第1组由55例接受传统经泪小管激光泪囊鼻腔造口术治疗的患者组成。第2组由36例患者组成，他们接受了相同的手术操作，但在激光截骨术前增加了鼻黏膜切除。比较两组的术中手术造口大小、围手术期和术后并发症、手术时间和成功率。
每组的平均随访期分别为8.88±2.99个月和10.28±4.47个月（p = 0.077）。术中平均手术造口大小分别为31.85±14.98毫米和42.25±18.09毫米（p = 0.004）。第1组的平均手术时间明显短于第2组（分别为18.55±4.05分钟和24.44±3.18分钟，p = 0.0001）。第1组的总体成功率为65.45%，第2组为75.00%（p = 0.335）。
虽然第2组的手术造口面积明显更大，但两组之间的手术成功率和患者满意度没有显著差异。
