Kim Dong Ju, Baek Sehyun, Chang Minwook
Department of Ophthalmology, Dongguk University Ilsan Hospital, 27, Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-773, South Korea.
Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2019 Jul;257(7):1535-1540. doi: 10.1007/s00417-019-04303-4. Epub 2019 Apr 29.
To evaluate the clinical usefulness of the dacryoscintigraphy in patients with nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy.
One hundred thirty-five lacrimal views of endoscopic dacryocystorhinostomy (DCR) with a single surgeon for primary nasolacrimal duct obstruction (PANDO) were included. These were assigned into three groups according to the type of dacryoscintigraphy. Group 1 was a pre-sac obstruction pattern. Group 2 was an intra-sac obstruction pattern. Group 3 was post-sac obstruction pattern. Each group was evaluated for an anatomical and functional surgical success, presence of complications including granuloma, synechiae, and tube-induced inflammation at least 12 months after the surgery.
Both anatomical and functional success rate showed no significant difference among the three groups (P = .297 and .472 linear by linear association). Functional failure rate (functional failure/total failure) also showed no clinically significant differences between groups. Logistic regression analysis was performed to determine the factors associated with functional success. There were no statistically significant factors in age, sex, scintigraphy type, pre-operative endoscopic grade, post-operative granuloma, and synechiae.
In patients with nasolacrimal duct obstruction, preoperative evaluation of obstruction level using dacryoscintigraphy may be not useful for predicting the functional success of the endoscopic dacryocystorhinostomy.
评估泪道闪烁造影术在内镜下泪囊鼻腔造口术治疗鼻泪管阻塞患者中的临床应用价值。
纳入由单一外科医生进行的135例原发性鼻泪管阻塞（PANDO）的内镜下泪囊鼻腔造口术（DCR）的泪道影像。根据泪道闪烁造影术的类型将其分为三组。第1组为泪囊前阻塞型。第2组为泪囊内阻塞型。第3组为泪囊后阻塞型。对每组患者在术后至少12个月时进行解剖学和功能手术成功率评估，以及并发症（包括肉芽肿、粘连和置管引起的炎症）的评估。
三组之间的解剖学和功能成功率均无显著差异（线性趋势检验P = 0.297和0.472）。功能失败率（功能失败/总失败）在各组之间也无临床显著差异。进行逻辑回归分析以确定与功能成功相关的因素。年龄、性别、闪烁造影术类型、术前内镜分级、术后肉芽肿和粘连等方面均无统计学显著因素。
对于鼻泪管阻塞患者，术前使用泪道闪烁造影术评估阻塞水平可能无助于预测内镜下泪囊鼻腔造口术的功能成功情况。
