Bani-Ata Majid, Aleshawi Abdelwahab, Ahmad Muayyad, Saleh Omar, Ashour Raneem, Khalil Hanen, Alomari Safwan, Alhowary Ala A A
Otolaryngology Branch, Department of Special Surgery, Jordan University of Science and Technology, P.O Box 3030, Irbid, 22110, Jordan.
Intern, King Abdullah Hospital, Irbid, 22110, Jordan.
Ann Med Surg (Lond). 2020 Apr 8;54:1-5. doi: 10.1016/j.amsu.2020.03.005. eCollection 2020 Jun.
Dacryocystorhinostomy (DCR) is a procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct obstructed. This study aimed to compare the success rates of two different techniques in endonasal endoscopic DCR; namely single and double mucosal flap techniques.
A nonequivalent quasi-experiment design was used in this study. Retrospectively, patients underwent endoscopic DCR for primary nasolacrimal duct (NLD) obstruction were included. Patients were divided into the single-flap technique and the double-flap technique groups. Success was defined as the achievement of patency of the NLD throughout the period of follow-up with significant improvement in epiphora.
Overall, 77 cases were included in the final analysis. Mean age was 41 years and 60% were female. Forty-six cases underwent the single-flap technique and 31 cases underwent the double-flap technique. Recurrence of NLD obstruction occurred in 11 (23.9%) cases in the single-flap group and in only one case (3.2%) in the double-flap group.
The modified double-flap technique for primary NLD obstruction resulted in less recurrence compared to the single-flap technique. Creating double flaps to cover any exposed lacrimal bone may reduce the rate of postoperative adhesions over the nasolacrimal duct ostium.
泪囊鼻腔吻合术（DCR）是一种在鼻泪管阻塞时恢复泪液从泪囊流入鼻腔的手术。本研究旨在比较鼻内镜下DCR两种不同技术（即单黏膜瓣技术和双黏膜瓣技术）的成功率。
本研究采用非等效准实验设计。回顾性纳入因原发性鼻泪管（NLD）阻塞接受内镜下DCR的患者。患者分为单瓣技术组和双瓣技术组。成功定义为在随访期间NLD通畅且溢泪有显著改善。
总体而言，77例患者纳入最终分析。平均年龄41岁，60%为女性。46例采用单瓣技术，31例采用双瓣技术。单瓣组有11例（23.9%）发生NLD阻塞复发，双瓣组仅1例（3.2%）复发。
与单瓣技术相比，改良双瓣技术治疗原发性NLD阻塞复发率更低。制作双瓣以覆盖任何暴露的泪骨可能会降低鼻泪管造口处术后粘连的发生率。
