Welham R A, Bergin D J
Arch Ophthalmol. 1985 Apr;103(4):545-8. doi: 10.1001/archopht.1985.01050040087025.
Twenty-one patients had surgical procedures for symptomatic cogenital lacrimal fistulas. The symptoms were epiphora from birth in 18 patients and late-onset epiphora in three cases. Thirteen patients had nasolacrimal obstruction at the upper duct or sac level. There were 21 dacryocystorhinostomies with fistula excision and canalicular intubation, and one patient had excision of the fistula tract only. The fistulas originated from the tear sac in only four cases and from the common canaliculus in 17; in one, the upper and lower canaliculus and the lacrimal fistula each had a separate opening into the lateral sac wall. The functional success rate was 95%. We recommend dacryocystorhinostomy with common canalicular dissection, fistula excision, and canalicular intubation for all patients with symptomatic congenital lacrimal fistulas to facilitate outflow and to avoid common canalicular obstruction.
21例患者因有症状的先天性泪瘘接受了外科手术。症状表现为18例患者自出生起即溢泪，3例患者为迟发性溢泪。13例患者在上泪道或泪囊水平存在鼻泪管阻塞。共进行了21例泪囊鼻腔吻合术，同时切除瘘管并进行泪小管插管，1例患者仅切除了瘘管通道。仅4例瘘管起源于泪囊，17例起源于泪总管；1例患者的上下泪小管及泪瘘分别开口于泪囊外侧壁。功能成功率为95%。我们建议，对于所有有症状的先天性泪瘘患者，均采用泪囊鼻腔吻合术，同时进行泪总管分离、瘘管切除及泪小管插管，以促进泪液引流并避免泪总管阻塞。
