Bernal Sprekelsen M
Hospital Son Dureta, Servicio De O.R.L.
An Otorrinolaringol Ibero Am. 1994;21(1):91-9.
The results of 104 endoscopically controlled dacryocystorhinostomies performed in 93 patients from June 1989 to June 1993 are presented. Postoperatively, 38 patients had a hematoma, 12 a subcutaneous emphysema and three patients an intraorbital emphysema. All complications were transitory. On 89 sides (85.57%) dacryorrhea was completely cured, on ten sides (9.61%) it was eased considerably, and it was not resolved in five cases, of whom, two had been operated through an external approach previously. A closed postoperative care is important in order to achieve good results. In 25.6% of the cases, the anterior ethmoid displayed patterns of a chronic inflammation. Its involvement in the pathogenesis of chronic dacrocystitis has to be discussed. In many cases, the localisation of the lacrimal gland is more posteriorly than described in anatomy leading to an impeded drainage and subsequently to dacryoadenitis. In our hands, the endoscopically controlled dacryocystorhinostomy presents as a save approach and a good alternative to the procedure described by Toti.
本文展示了1989年6月至1993年6月期间对93例患者进行的104次内镜控制下泪囊鼻腔造口术的结果。术后，38例患者出现血肿，12例出现皮下气肿，3例出现眶内气肿。所有并发症均为暂时性。89侧（85.57%）泪溢完全治愈，10侧（9.61%）明显缓解，5例未缓解，其中2例曾行外路手术。术后封闭护理对于取得良好效果很重要。25.6%的病例中，筛前显示慢性炎症模式。必须讨论其在慢性泪囊炎发病机制中的作用。在许多情况下，泪腺的位置比解剖学描述的更靠后，导致引流受阻，继而引发泪腺炎。在我们的经验中，内镜控制下泪囊鼻腔造口术是一种安全的方法，是托蒂所描述手术的良好替代方案。
