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在获得性泪囊黏液囊肿中,有或没有双泪小管硅胶管插管的内镜下泪囊鼻腔造口术结果比较。

Comparison of Endoscopic Dacryocystorhinostomy Outcomes With or Without Bicanalicular Silicone Tube Intubation in Acquired Lacrimal Sac Mucocele.

作者信息

Lan Shan, Yu Jinqiang, Ke Feng, Li Dekun, Liu Zhenkai

机构信息

Department of Radiology, Renmin Hospital, Hubei University of Medicine.

Department of Ophthalmology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.

出版信息

J Craniofac Surg. 2023 Oct 1;34(7):e671-e675. doi: 10.1097/SCS.0000000000009581. Epub 2023 Aug 15.

Abstract

PURPOSE

This paper was established to validate the necessity of bicanalicular silicone tube intubation (BSTI) in patients with acquired lacrimal sac mucocele (ALSM) receiving endoscopic dacryocystorhinostomy (DCR).

METHODS

In total, 92 patients (92 eyes) diagnosed with ALSM undergone endoscopic DCR from November 2016 to December 2021 were recruited for our research. Patients were allocated into 2 equal treatment groups: group A (patients undergoing BSTI) and group B (patients not receiving this procedure). The tubes were removed 2 months postoperation in group A. Surgical outcomes and related complications were evaluated 12 months postoperation.

RESULTS

Ultimately, this study included 83 patients with ALSM, consisting of 43 patients in group A and 40 patients in group B. All patients exhibited notable mass shrinkage with the opening of the lacrimal sac during the surgery and the swelling in the lacrimal sac area was completely relieved within 5 days postoperation. At the 12-month follow-up, no distinct difference was observed in the anatomic success rate between the 2 groups (group A: 93.0%; group B: 90.0%) ( t = 0.010, P > 0.05). However, patients in group A presented higher functional success rates (90.7%) in contrast to those patients in group B (72.5%) ( t = 4.635, P < 0.05). In both groups, the failure of the lacrimal passage reconstruction was attributed to granulation tissue formation or scar formation at the ostium. No sac mucocele recurrence occurred during the follow-up.

CONCLUSION

Endoscopic DCR treatment for ALSM achieves satisfactory postoperative effects without recurrence, and BSTI may improve the functional success rate.

摘要

目的

本文旨在验证在接受内镜下泪囊鼻腔造口术(DCR)的获得性泪囊黏液囊肿(ALSM)患者中行双泪小管硅胶管插管术(BSTI)的必要性。

方法

总共招募了92例在2016年11月至2021年12月期间诊断为ALSM并接受内镜下DCR的患者(92只眼)进行研究。将患者分为2个相等的治疗组:A组(行BSTI的患者)和B组(未接受该操作的患者)。A组在术后2个月取出导管。在术后12个月评估手术效果和相关并发症。

结果

最终,本研究纳入了83例ALSM患者,其中A组43例,B组40例。所有患者在手术过程中泪囊开放时均表现出明显的肿物缩小,术后5天内泪囊区肿胀完全消退。在12个月的随访中,两组间解剖成功率无明显差异(A组:93.0%;B组:90.0%)(t = 0.010,P > 0.05)。然而,A组患者的功能成功率(90.7%)高于B组患者(72.5%)(t = 4.635,P < 0.05)。在两组中,泪道重建失败均归因于造口处肉芽组织形成或瘢痕形成。随访期间未发生泪囊黏液囊肿复发。

结论

内镜下DCR治疗ALSM术后效果满意,无复发,BSTI可能提高功能成功率。

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