Department of Ophthalmology, University of California San Francisco, San Francisco, California.
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
J AAPOS. 2024 Apr;28(2):103865. doi: 10.1016/j.jaapos.2024.103865. Epub 2024 Mar 6.
To compare outcomes and complications of three surgical techniques for the treatment of congenital dacryocystoceles: nasolacrimal probing and irrigation (P+I), P+I plus nasal endoscopy (NE) with intranasal cyst marsupialization, and primary NE with intranasal cyst marsupialization.
The medical records of children ≤2 years of age at a single academic center with a diagnosis of dacryocystocele from 2012 to 2022 were retrospectively identified and reviewed. The primary outcome was resolution of the dacryocystocele (ie, elimination of the medial canthal mass and resolution of tearing or discharge) after a single procedure ("primary success"). Surgical techniques were compared using exact logistic regression.
Of 54 patients, 21 (39%) underwent P+I, 23 (43%) underwent P+I plus nasal endoscopy, and 10 (18%) underwent primary NE. Primary success was 76% for P+I and 100% for the other two cohorts. Most patients (89%) who underwent P+I received general anesthesia compared with none who underwent primary nasal endoscopy. Most complications were related to the use of general anesthesia, with a complication rate of 10% for P+I, 48% for P+I plus NE, and 0% for primary NE. Most P+I procedures required hospital admission compared to half of primary NE procedures.
In our study cohort, primary NE provided good outcomes and was associated with a lower complication rate than P+I with or without NE.
比较三种手术技术治疗先天性泪囊囊肿的结果和并发症：鼻泪管探通和冲洗（P+I）、P+I 加鼻内窥镜（NE）伴鼻腔内囊肿袋形术，以及原发性 NE 伴鼻腔内囊肿袋形术。
回顾性分析了 2012 年至 2022 年在一家学术中心就诊的≤2 岁儿童的病历，这些儿童被诊断为先天性泪囊囊肿。主要结果是单次手术后泪囊囊肿的消退（即消除内眦肿块和流泪或溢液的缓解）（“原发性成功”）。使用确切的逻辑回归比较手术技术。
在 54 例患者中，21 例（39%）接受了 P+I，23 例（43%）接受了 P+I 加鼻内窥镜检查，10 例（18%）接受了原发性 NE。P+I 的原发性成功率为 76%，而其他两组的原发性成功率为 100%。与原发性鼻内窥镜检查相比，接受 P+I 的大多数患者（89%）接受了全身麻醉。大多数并发症与全身麻醉的使用有关，P+I 的并发症发生率为 10%，P+I+NE 的并发症发生率为 48%，原发性 NE 的并发症发生率为 0%。与原发性鼻内窥镜检查相比，大多数 P+I 手术需要住院治疗，而半数原发性鼻内窥镜检查不需要住院治疗。
在我们的研究队列中，原发性 NE 提供了良好的结果，并且与 P+I 或 P+I+NE 相比，并发症发生率较低。
