State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, 54 South Xianlie Road, Guangzhou, 510060, China.
Ophthalmologic Center, The First People's Hospital of Kashi Prefecture, The Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, 844000, China.
Eur Arch Otorhinolaryngol. 2024 Nov;281(11):5783-5792. doi: 10.1007/s00405-024-08797-5. Epub 2024 Aug 6.
This study aims to present long-term outcomes in a specific patient population experiencing epiphora due to low-level nasolacrimal duct obstruction (NLDO) following endonasal endoscopic nasolacrimal duct rhinostomy, and to propose a surgical selection paradigm for varying locations of NLDO.
Between September 1, 2017 and February 28, 2023, a retrospective analysis was conducted on 26 patients diagnosed with primary acquired nasolacrimal duct obstruction (PANDO) who underwent endonasal endoscopic nasolacrimal duct rhinostomy for low-level NLDO (defined as obstruction below the plane of the superior border of the inferior turbinate attachment). The study assessed surgical success through objective measures of anatomical patency and subjective measures of functional patency during a postoperative follow-up period of at least six months. Additionally, any complications that arose during this follow-up period were documented.
The study included a cohort of 26 patients, consisting of 24 women and 2 men, with a mean age of 47.58 ± 3.09 years (range: 8-75). All patients underwent endoscopic nasolacrimal duct rhinostomy, with 10 eyes having previously undergone tear duct recanalization procedures. Anatomical patency was achieved in 88.5% (23/26) of cases, while functional patency was achieved in 80.8% (21/26) after an average follow-up period of 41.9 ± 22.1 months. No significant complications were observed in any of the patients during the follow-up period.
Endonasal endoscopic nasolacrimal duct rhinostomy is effective in treating epiphora in over 80% of cases with low-level NLDO. Tailoring the surgery to the location of the obstruction can improve outcomes and minimize damage.
本研究旨在展示特定患者人群因低位鼻泪管阻塞（NLDO）经鼻内镜鼻内泪囊鼻腔吻合术后出现溢泪的长期结果，并提出一种针对不同位置 NLDO 的手术选择模式。
2017 年 9 月 1 日至 2023 年 2 月 28 日，对 26 例经鼻内镜鼻内泪囊鼻腔吻合术治疗低位 NLDO（定义为阻塞在下鼻甲附着的下鼻甲上缘平面以下）的原发性获得性鼻泪管阻塞（PANDO）患者进行回顾性分析。研究通过术后至少 6 个月的随访期内解剖通畅的客观测量和功能通畅的主观测量评估手术成功率。此外，还记录了在此随访期间出现的任何并发症。
研究纳入了 26 例患者，包括 24 名女性和 2 名男性，平均年龄为 47.58 ± 3.09 岁（范围：8-75 岁）。所有患者均接受了内镜鼻内泪囊鼻腔吻合术，其中 10 只眼先前已行泪小管再通术。26 例患者中有 88.5%（23/26）达到解剖通畅，平均随访 41.9 ± 22.1 个月后有 80.8%（21/26）达到功能通畅。在随访期间，没有患者出现明显并发症。
鼻内镜鼻内泪囊鼻腔吻合术治疗低位 NLDO 导致的溢泪有效，超过 80%的患者可获得满意效果。根据阻塞位置调整手术可改善手术效果并减少损伤。
