Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
J Craniofac Surg. 2021;32(5):1942-1945. doi: 10.1097/SCS.0000000000007416.
To investigate whether self-cross-linked HA hydrogel fill stimulates wound mucosal regeneration and its epithelialization around the ostia to improve long-term ostial patency in endonasal endoscopic dacryocystorhinostomy (En-DCR).
One hundred and ninety-two patients with unilateral primary chronic dacryocystitis (PCD) were randomized divided into 2 groups: group A (the HA hydrogel group) and group B (the control group). All patients underwent En-DCR. The HA hydrogel group received HA hydrogel filling the ostium at the end of the surgery and the control group received no treatment. The mucosal epithelialization of the wound, the formation of granulation, the formation of scars, and the success rate of ostial patency were compared.
Our study included 82 patients in group A and 79 patients in group B. At the 2-week follow up, 74 patients (90.2%) in the group A had a healed ostium with a lining of intact epithelial mucosa. It was higher when compared with 56 patients (70.9%) in group B (X2 = 9.698, P < 0.05). At the 12-month follow up, Granulation were present in 7.3% of patients in group A which was significantly lower than the 19.0% of patients in group B (X2 = 4.831, P < 0.05). No statistical difference was found with scars formation between 2 groups (X2 = 1.607, P = 0.205). The success rate of ostial patency was 89.0% (73/82) in group A and 77.2% (61/79) in group B. The success rate was much higher in group A than group B (X2 = 4.02, P < 0.05).
Self-cross-linked HA hydrogel may enhance the success rate of En-DCR for PCD by promoting mucosal epithelial healing and preventing excessive granulation.
研究自交联 HA 水凝胶填充是否能刺激鼻内内窥镜下泪囊鼻腔吻合术（En-DCR）中泪囊造口周围的伤口黏膜再生及其上皮化，从而改善造口的长期通畅性。
将 192 例单侧原发性慢性泪囊炎（PCD）患者随机分为 2 组：A 组（HA 水凝胶组）和 B 组（对照组）。所有患者均行 En-DCR 手术。HA 水凝胶组在手术结束时接受 HA 水凝胶填充造口，对照组则不做任何处理。比较两组患者的伤口黏膜上皮化、肉芽组织形成、瘢痕形成和造口通畅率。
本研究纳入 A 组 82 例，B 组 79 例。A 组术后 2 周时，74 例（90.2%）造口愈合，有完整上皮黏膜覆盖；高于 B 组的 56 例（70.9%）（X2=9.698，P＜0.05）。A 组在术后 12 个月随访时，有 7.3%的患者出现肉芽组织，明显低于 B 组的 19.0%（X2=4.831，P＜0.05）。两组患者的瘢痕形成无统计学差异（X2=1.607，P=0.205）。A 组造口通畅率为 89.0%（73/82），B 组为 77.2%（61/79）。A 组的通畅率明显高于 B 组（X2=4.02，P＜0.05）。
自交联 HA 水凝胶通过促进黏膜上皮愈合和防止过度肉芽组织形成，可能提高 En-DCR 治疗 PCD 的成功率。
