Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographicdacryocystography research  

作　　者：Xin-Han Cui Yan-Wen Fang Li-Min Zhang Ji-Ni Qiu Chao-Ran Zhang Yan Wang 

机构地区：[1]Eye Institute and Department of Ophthalmology,Eye and ENT Hospital of Fudan University,Shanghai 200031,China [2]NHC Key laboratory of Myopia and Related Eye Diseases,Key Laboratory of Myopia and Related Eye Diseases,Chinese Academy of Medical Sciences,Shanghai 200031,China [3]Shanghai Key Laboratory of Visual Impairment and Restoration,Shanghai 200031,China [4]Department of Ophthalmology,Children’s Hospital of Kaifeng,Kaifeng 475000,Henan Province,China

出　　处：《International Journal of Ophthalmology(English edition)》2025年第2期251-257,共7页国际眼科杂志(英文版)

基　　金：Supported by the National Natural Science Foundation of China(No.81700807).

摘　　要：AIM:To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy(EN-DCR).METHODS:This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients.Computed tomographic-dacryocystography(CT-DCG)scans were performed before lacrimal surgery,and image reconstruction was used to obtain continuous 0.75-mm axial,coronal,and segmental sections for review.The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement,as well as the obstructed location.RESULTS:The height of the lacrimal sac was 12.99±2.10 mm in this study.The operculum of the middle turbinate(OMT)was located vertically in the lower third of the lacrimal sac.Horizontally,the junction between the maxillary bone and the lacrimal bone(MB-LB)was close to,mostly(60.2%)posterior to,the lacrimal sac.The uncinate process was more frequently attached to the lacrimal bones(75.1%).The obstructions were generally located around the entrance of the nasolacrimal duct(NLD).However,some were placed higher,with 7.63%blocked not lower than the OMT.There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction(r=-0.35,P<0.01).CONCLUSION:In this study,the OMT and MB-LB can be served as the landmarks in EN-DCR.Partial uncinectomy should be performed in most cases.The obstructions were generally located around the entrance of the NLD,but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery.

关 键 词：lacrimal sac nasolacrimal duct obstruction endoscopic dacryocystorhinostomy computed tomographic-dacryocystography 

分 类 号：R739.7[医药卫生—肿瘤]