Sharma Bhavana, Aslam M
Department of ENT, Jawaharlal Nehru Medical College and Hospital, 5/19, New Rajendra Nagar, Near Banna Devi, Aligarh, Uttarpradesh 202001 India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4405-4410. doi: 10.1007/s12070-024-04874-7. Epub 2024 Jul 22.
Epiphora is an annoying symptom, embarrassing the patient both socially and functionally. The two widely accepted treatment modalities of epiphora resulting from obstruction of the nasolacrimal ductus are external and endoscopic dacryocystorhinostomy (DCR). To compare the outcome of endonasal endoscopic dacryocystorhinostomy with stent and without stent prospectively and to compare the outcome of endonasal endoscopic dacryocystorhinostomy with stent and without stent with external dacryocystorhinostomy retrospectively. This retrospective and prospective clinical interventional study was done in the Department of Otorhinolaryngology and Institute of Ophthalmology, Jawaharlal Nehru Medical College, A.M.U., Aligarh from July 2012 to September 2017. 110 patients of epiphora participated in the study and were divided into three groups: Group I: Endoscopic endonasal dacryocystorhinostomy with stent. Group II: Endoscopic endonasal dacryocystorhinostomy without stent. Group III: External dacryocystorhinostomy. Out of them 60 patients were for Endoscopic dacryocystorhinostomy (30 patients with stent and 30 patients without stent) and 50 patients were for External dacryocystorhinostomy. 71 (65%) were females while 39 (35%) were males ( < 0.05) with age ranging from ranging 8-60 years (mean 34.96 years) with predominance of symptoms in left eye ( < 0.01). A lower complication rate was observed in the endoscopic group, with minimal morbidity and shorter operative time compared with the external approach. Follow up was done at postoperative day 1st and 7th, at 2 weeks, 4 weeks and 3 months for assessing complications of operation, symptomatic relief of epiphora and syringing for anatomical patency. In our study, Success rate was 93.30% in Group I and 96.60% in Group II while 90% in group III. The avoidance of a cutaneous scar has been a strong impetus to further the success and improve outcomes of endonasal DCR. Endonasal DCR without stent has lesser incidence of post-operative fibrosis and higher patient's acceptance.
溢泪是一种令人烦恼的症状，在社交和功能方面都会使患者感到尴尬。鼻泪管阻塞引起的溢泪，两种广泛接受的治疗方式是外路泪囊鼻腔吻合术（DCR）和内镜下泪囊鼻腔吻合术。前瞻性比较有支架和无支架的鼻内镜下泪囊鼻腔吻合术的效果，并回顾性比较有支架和无支架的鼻内镜下泪囊鼻腔吻合术与外路泪囊鼻腔吻合术的效果。这项回顾性和前瞻性临床干预研究于2012年7月至2017年9月在阿利加尔穆斯林大学贾瓦哈拉尔·尼赫鲁医学院耳鼻喉科和眼科研究所进行。110例溢泪患者参与了研究，分为三组：第一组：带支架的鼻内镜下泪囊鼻腔吻合术。第二组：无支架的鼻内镜下泪囊鼻腔吻合术。第三组：外路泪囊鼻腔吻合术。其中60例患者接受内镜下泪囊鼻腔吻合术（30例带支架，30例无支架），50例患者接受外路泪囊鼻腔吻合术。71例（65%）为女性，39例（35%）为男性（P<0.05），年龄范围为8至60岁（平均34.96岁），左眼症状占优势（P<0.01）。内镜组并发症发生率较低，与外路手术相比，发病率最低，手术时间更短。术后第1天和第7天、2周、4周和3个月进行随访，以评估手术并发症、溢泪症状缓解情况以及冲洗检查解剖结构通畅情况。在我们的研究中，第一组成功率为93.30%，第二组为96.60%，第三组为90%。避免皮肤瘢痕是推动鼻内镜下泪囊鼻腔吻合术取得成功并改善疗效的强大动力。无支架的鼻内镜下泪囊鼻腔吻合术术后纤维化发生率较低，患者接受度较高。
