Ptok A, Draf W
HNO. 1987 May;35(5):188-94.
After a short review of anatomy the clinical and radiological diagnosis of stenoses of the lacrimal duct system are discussed in detail. Microcatheterdacryocystography and high resolution CT are very important in determining the indications for surgery. Microsurgical endonasal dacryocystorhinostomy is preferred for treatment of postsaccal stenoses. It is also the method of choice for one stage definitive therapy of acute lacrimal sac empyema. Surgical reconstruction in cases of presaccal stenoses is difficult and should be handled individually. For intubation of the canaliculi we have developed a special modified pigtail-hollow-probe (Draf-Haag 1981), which reduces damage to the epithelium. If reconstruction of the natural lacrimal duct system is not possible, a conjunctivorhinostomy by Walter's technique is indicated. The different surgical concepts and results are discussed.
在对解剖结构进行简短回顾后，详细讨论了泪道系统狭窄的临床和放射学诊断。微导管泪囊造影和高分辨率CT在确定手术适应症方面非常重要。鼻内镜下泪囊鼻腔造口术是治疗泪囊后段狭窄的首选方法。它也是急性泪囊积脓一期确定性治疗的首选方法。泪囊前段狭窄病例的手术重建困难，应个体化处理。对于泪小管插管，我们开发了一种特殊改良的猪尾空心探针（Draf-Haag 1981），可减少对上皮的损伤。如果无法重建天然泪道系统，则需采用沃尔特技术进行结膜鼻腔造口术。文中讨论了不同的手术理念和结果。
