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原发性探通术联合或不联合 Monoka 硅橡胶支架插管治疗大龄儿童和成人的溢泪。

Primary Probing with and without Monoka Silastic Stent Intubation for Epiphora in Older Children and Adults.

机构信息

From the Department of Pediatric Ophthalmology and Strabismus, Erciyes University Medical Faculty, Kayseri, Türkiye.

出版信息

Curr Eye Res. 2020 Jan;45(1):87-90. doi: 10.1080/02713683.2019.1643026. Epub 2019 Aug 15.

Abstract

: To report the results of primary probing with and without monocanalicular silastic stent intubation for the relief of chronic epiphora in older children and adults and to assess its effectivity on final surgical outcome.: An uncontrolled surgical trial was designed. A total of 124 eyes of 102 patients (90 female, 12 male; 80 unilateral, 22 bilateral) with uncomplicated nasolacrimal ductus obstruction had primary probing with and without monocanalicular silastic stent intubation by a Ritleng probe. Symptomatic relief of epiphora and positive dye test were established as success. The time of the operation was measured, the success rate was assessed, the advantages and disadvantages were evaluated and the surgical outcome was compared with our previous papers.: The mean age of the patients was 37.2 years (range, 6-59) with a mean follow-up period of 14.7 months (range, 6-24). The symptoms were present for a mean of 2.5 years (range, 6 months-5 years). Of 124 eyes, 21 cases underwent only primary probing whereas the remaining 103 had primary probing with monocanalicular silastic stent intubation. The operative time was 4.3 min (range, 3-12). The silastic stents were removed between third to six months. The overall success rates at the first visit (2 weeks after stent removal) and the last visit were 58.5% and 45.2% (56 cases), respectively. None of the cases demonstrated any per- or postoperative complications. All 68 failure eyes underwent uneventful external dacryocystorhinostomy, 65 (95.5%) of which were successful with the relief of previous symptoms at final visit.: Primary probing with or without monocanalicular silastic stent intubation may be tried initially in older children and adults with complete nasolacrimal duct obstructions, as this intervention does not prevent further possible conventional dacryocystorhinostomy in case of failure, speeds up the procedure, and avoids the disadvantages of invasive approaches.

摘要

: 报告原发性探查联合或不联合单通道硅橡胶支架插管治疗大龄儿童和成人慢性溢泪的结果,并评估其对最终手术结果的影响。: 设计了一项非对照性手术试验。共有 102 例患者(90 例女性,12 例男性;80 例单侧,22 例双侧)的 124 只眼患有单纯性鼻泪管阻塞,使用 Ritleng 探针进行了原发性探查联合或不联合单通道硅橡胶支架插管。溢泪症状缓解和染料试验阳性被确立为成功。测量手术时间,评估成功率,评估优缺点,并将手术结果与我们以前的论文进行比较。: 患者的平均年龄为 37.2 岁(范围为 6-59 岁),平均随访时间为 14.7 个月(范围为 6-24 个月)。症状出现的平均时间为 2.5 年(范围为 6 个月-5 年)。124 只眼中,21 只仅行原发性探查,其余 103 只眼行原发性探查联合单通道硅橡胶支架插管。手术时间为 4.3 分钟(范围为 3-12 分钟)。硅橡胶支架在 3-6 个月之间取出。首次就诊(支架取出后 2 周)和最后就诊的总体成功率分别为 58.5%和 45.2%(56 例)。无任何围手术期并发症。所有 68 例失败眼均行顺利的外鼻泪囊吻合术,最终随访时 65 例(95.5%)成功缓解了先前的症状。: 在大龄儿童和成人完全鼻泪管阻塞的情况下,可尝试行原发性探查联合或不联合单通道硅橡胶支架插管治疗,因为这种干预不会阻止进一步可能的常规鼻泪囊吻合术失败,加快手术进程,并避免侵入性方法的缺点。

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