Wesley R E
Ophthalmic Surg. 1985 Jun;16(6):368-71.
A group of 52 pediatric patients with lacrimal obstruction were considered to be high risk since they had been previously probed (27 patients) or were older (average age 23 months). At the time of probe and irrigation, a small, straight hemostat was placed into the nose to grasp the inferior turbinate and rotate it a full 90 degrees inward. All cases of congenital nasolacrimal duct obstruction (49) resolved following this maneuver. A small muscle hook with the tip directed upward was placed underneath the inferior turbinate to identify three patients with congenital nasolacrimal duct anomaly (absence or atresia of the nasolacrimal duct) who would not have benefitted from further probings and responded to dacryocystorhinostomy. Even though the results of our uncontrolled surgical trial cannot be compared to other treatment methods, the data suggest that even very difficult cases of congenital nasolacrimal duct obstruction will respond to a simple turbinate fracture with a hemostat without the necessity of complicated tubes or stents. A small muscle hook can be used to identify those rare cases of congenital nasolacrimal duct anomaly who may require specialized procedures such as dacryocystorhinostomy or inferior turbinectomy.
一组52例泪道阻塞的儿科患者被视为高危患者，因为他们之前接受过探通术（27例患者）或年龄较大（平均年龄23个月）。在进行探通和冲洗时，将一把小型直止血钳放入鼻腔以抓住下鼻甲并将其向内旋转整整90度。所有先天性鼻泪管阻塞病例（49例）在此操作后均得到解决。将一把尖端向上的小肌肉钩置于下鼻甲下方，以识别出3例先天性鼻泪管异常（鼻泪管缺失或闭锁）的患者，这些患者无法从进一步的探通术中获益，而对泪囊鼻腔吻合术有反应。尽管我们的非对照手术试验结果无法与其他治疗方法进行比较，但数据表明，即使是非常困难的先天性鼻泪管阻塞病例，也会对用止血钳进行的简单鼻甲骨折产生反应，而无需复杂的导管或支架。一个小肌肉钩可用于识别那些可能需要特殊手术（如泪囊鼻腔吻合术或下鼻甲切除术）的罕见先天性鼻泪管异常病例。
