Alokkan Jolene, Swathi R, Viswanatha B, Aishwarya N, James Grace Ann, Akshitha Vaddepalli
Department of Otorhinolaryngology, East Point College of Medical Sciences and Research Centre, Bangalore, India.
Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1882-1885. doi: 10.1007/s12070-023-04435-4. Epub 2023 Dec 19.
To evaluate the outcome and complications of Endoscopic endonasal Dacryocystorhinostomy (DCR) using an inferiorly based mucosal flap as compared to a conventional posteriorly based mucosal flap with flap preservation and no stenting. 36 patients presenting with nasolacrimal duct obstruction were divided into two groups: the first group underwent endoscopic DCR using an inferiorly based mucosal flap, and the other group used a posteriorly based mucosal flap. In both groups, the mucosal flap was preserved, and bone was removed using Kerrison's punch. No stenting was done in any of the cases. The patency of the ostia was determined by syringing, and nasal endoscopy was done to look at the neo-ostium at follow-up visits to determine success and complications in each group. All 18 cases in the inferiorly based flap group had patent ostia with good mucosalization of the neo-ostium at 6-month follow-up. 3 of the 18 cases in the conventional posteriorly based flap group had failure due to granulation tissue formation around the neo-ostium. The use of an inferiorly based mucosal flap is easy to fashion and reposition at the end of the surgery. This technique has a good outcome with patent ostia during the follow-up period of 6 months.
评估与采用保留黏膜瓣且不置管的传统后基底黏膜瓣相比，使用下基底黏膜瓣的鼻内镜下鼻泪管吻合术（DCR）的疗效和并发症。36例鼻泪管阻塞患者被分为两组：第一组采用下基底黏膜瓣进行鼻内镜下DCR，另一组采用后基底黏膜瓣。两组均保留黏膜瓣，使用克里森咬骨钳去除骨质。所有病例均未置管。通过冲洗确定造口通畅情况，并在随访时进行鼻内镜检查以观察新造口，从而确定每组的手术成功率和并发症情况。下基底瓣组的所有18例患者在6个月随访时造口均通畅，新造口黏膜化良好。传统后基底瓣组的18例患者中有3例因新造口周围肉芽组织形成而手术失败。使用下基底黏膜瓣在手术结束时易于制作和重新定位。在6个月的随访期内，该技术造口通畅，疗效良好。
