内镜下泪囊鼻腔造口术的重要更新
A critical update on endoscopic dacryocystorhinostomy.
作者信息
Locatello Luca Giovanni, Redolfi De Zan Enrico, Caiazza Nicole, Tarantini Anna, Lanzetta Paolo, Miani Cesare
机构信息
Department of Otorhinolaryngology, Academic Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.
出版信息
Acta Otorhinolaryngol Ital. 2024 Dec;44(6):351-360. doi: 10.14639/0392-100X-N2916.
OBJECTIVES
Endoscopic dacryocystorhinostomy (endo-DCR) is becoming a workhorse in the management of distal lacrimal duct obstruction. It yields success rates comparable to external DCR, with the advantage of no external scars. However, it requires multidisciplinary expertise and many uncertainties in terms of proper indications, technique, and perioperative management still exist.
METHODS
Systematic review of the literature in the last 5 years using PubMed and Google Scholar.
RESULTS
A total of 66 articles were included. Many technical modifications and surgical refinements have been proposed, but a formal comparison of the various techniques is hampered by methodological heterogeneity. The use of local anaesthesia and perioperative adjunctive techniques to reduce the risk of restenosis are also gaining popularity even if the level of evidence remains weak.
CONCLUSIONS
Endo-DCR offers satisfactory clinical outcomes even though there are many grey areas that need to be addressed in future high-quality studies.
目的
内镜下泪囊鼻腔造口术（endo-DCR）正成为治疗泪道远端阻塞的主要方法。其成功率与外路泪囊鼻腔造口术相当，且具有无外部瘢痕的优势。然而，该手术需要多学科专业知识，在合适的适应症、技术及围手术期管理方面仍存在诸多不确定性。
方法
使用PubMed和谷歌学术对过去5年的文献进行系统综述。
结果
共纳入66篇文章。人们提出了许多技术改进和手术优化方法，但由于方法学的异质性，阻碍了对各种技术进行正式比较。即使证据水平仍然薄弱，使用局部麻醉和围手术期辅助技术以降低再狭窄风险也越来越普遍。
结论
尽管存在许多需要在未来高质量研究中解决的灰色地带，但endo-DCR仍能提供令人满意的临床结果。
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