Zilelioğlu G, Uğurbaş S H, Anadolu Y, Akiner M, Aktürk T
Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.
Br J Ophthalmol. 1998 Jan;82(1):63-6. doi: 10.1136/bjo.82.1.63.
Endoscopic endonasal dacryocystorhinostomy (DCR) has some advantages over external DCR as a less invasive method with no skin incisions. But the success rate of the operation has not reached the level of external method. In this study, a wound healing inhibitor mitomycin C was used intraoperatively to prevent the closure of the osteum after the operation.
Endoscopic endonasal DCR was performed on 40 eyes of 39 patients (26 female, 13 male). Mitomycin C was applied to the ostium in 14 of 23 patients who had undergone primary endoscopic DCR by means of a microdrill and in eight of 17 patients who had a revision endoscopic DCR secondary to a previously failed external DCR.
The postoperative follow up period was 9-27 (mean 18.2) months. The success rate of endoscopic DCR with intraoperative mitomycin C was 77.3%, whereas the success rate of endoscopic DCR without mitomycin C was 77.8%. The statistical analysis did not show a difference between the two groups according to the ostium size and their success rates.
Adjunctive use of a wound healing inhibitor is considered to increase the success rate of endoscopic endonasal DCR. Its intraoperative use seems to be easy and safe. But the study of this limited series shows no benefit in using it.
鼻内镜下泪囊鼻腔造口术（DCR）作为一种侵入性较小且无皮肤切口的方法，相较于外路DCR具有一些优势。但该手术的成功率尚未达到外路手术的水平。在本研究中，术中使用伤口愈合抑制剂丝裂霉素C以防止术后造口闭合。
对39例患者（26例女性，13例男性）的40只眼进行鼻内镜下泪囊鼻腔造口术。在23例行初次鼻内镜DCR的患者中，14例通过微型钻将丝裂霉素C应用于造口；在17例因既往外路DCR失败而行鼻内镜DCR修复术的患者中，8例应用丝裂霉素C。
术后随访时间为9 - 27（平均18.2）个月。术中使用丝裂霉素C的鼻内镜DCR成功率为77.3%，而未使用丝裂霉素C的鼻内镜DCR成功率为77.8%。根据造口大小及其成功率进行的统计学分析显示两组之间无差异。
辅助使用伤口愈合抑制剂被认为可提高鼻内镜下泪囊鼻腔造口术的成功率。术中使用似乎简便且安全。但本有限系列研究表明使用它并无益处。
