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经下眼睑内侧三分之一肿瘤切除术后,使用单通道探针进行功能性下泪小管重建。

Functional inferior canalicular reconstruction using a monocanalicular probe after tumor resection of the medial third of the lower eyelid.

机构信息

Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain; Innova Ocular Verte Barcelona, Vía Augusta 61, 08006 Barcelona, Spain.

Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain.

出版信息

J Fr Ophtalmol. 2024 Sep;47(7):104236. doi: 10.1016/j.jfo.2024.104236. Epub 2024 Jun 15.

Abstract

PURPOSE

To describe a surgical technique for functionally reconstructing a lacrimal drainage duct and to assess its long-term functionality.

METHODS

This observational review includes six cases involving reconstruction of the inferior canaliculus after surgical resection of lower eyelid carcinoma. Following lesion excision with safety margins, the epithelium of the distal portion of the inferior canaliculus is located and intubated with a monocanalicular probe. Subsequently, the eyelid lamellae are reconstructed without displacing the probe. The Monoka collarette is then sutured using a 10/0 nylon suture. Data collection included anatomic pathology of the lesion and data from ophthalmic examinations at each visit (including epiphora, inferior canalicular irrigation, and fluorescein dye disappearance test [FDDT]), as well as stent extrusion or other complications.

RESULTS

No complications were observed during the surgeries. The stents remained in place for an average of 4months, with no extrusions prior to removal. The mean follow-up period was 4.8years (SD=2.0), during which no other complications were noted. Only one patient experienced intermittent epiphora, also present in the fellow eye. At the final visit, FDDT was normal in all eyes, and all patients demonstrated patency of the inferior canaliculus upon irrigation.

CONCLUSION

Primary reconstruction of an inferior lacrimal drainage duct following tumor resection can be successfully performed, resulting in favorable functional recovery.

摘要

目的

描述一种功能性重建泪道的手术技术,并评估其长期功能。

方法

本观察性回顾性研究纳入 6 例因下眼睑癌切除术后重建下泪小管的病例。在安全切缘切除病变后,找到下泪小管远端的上皮并插入单通道探针。然后,在不移动探针的情况下重建眼睑板。最后,使用 10/0 尼龙缝线缝合 Monoka 领圈。数据收集包括病变的解剖病理学以及每次就诊时的眼科检查数据(包括溢泪、下泪小管冲洗和荧光素染料消失试验 [FDDT]),以及支架脱出或其他并发症。

结果

手术过程中无并发症发生。支架平均留置 4 个月,在取出前无脱出。平均随访时间为 4.8 年(SD=2.0),在此期间未观察到其他并发症。只有 1 例患者出现间歇性溢泪,对侧眼也存在这种情况。在最后一次就诊时,所有眼睛的 FDDT 均正常,所有患者在冲洗时下泪小管均通畅。

结论

肿瘤切除后可成功进行下泪道的初次重建,从而获得良好的功能恢复。

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