泪囊鼻腔造孔术后远期闭锁与鼻泪管复通现象  

Observation of scarred closed ostiums long time after endoscopic dacryocystorhinostomy and reopening of nasal lacrimal duct

作　　者：周兵[1] 黄谦[1] 韩德民[1] 唐忻[2] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉科,北京100730 [2]首都医科大学附属北京同仁医院眼科,北京100730

出　　处：《眼科》2004年第2期95-97,共3页Ophthalmology in China

摘　　要：目的 :报告 2 75例 (310只眼 )慢性泪囊炎接受鼻内镜下经鼻行泪囊鼻腔造孔术治疗后 ,9只眼患者自然泪道复通现象。方法 :2 75例 (310只眼 )慢性泪囊病变患者接受鼻内镜下泪囊鼻腔造孔术 ,手术在局部或全身麻醉下进行。术后随访包括鼻内镜检查处理、泪道冲洗及鼻腔局部应用糖皮质激素。结果 :随访 3～ 6 0个月 ,治愈率 75 3% ,好转率 11 7% ,总有效率为 87 0 % ,无效为 13 0 %。 2 75例 (310只眼 )中 ,9只眼术后 1年泪囊鼻腔造孔瘢痕闭锁 ,冲洗液自泪囊鼻腔自然开口流出。结论 :慢性泪囊炎泪道下端阻塞并非完全不可逆 ,在手术造孔、建立泪液旁路引流途径之后 ,原来阻塞的鼻泪管局部粘膜炎症可以缓解 ,重新发挥泪液排出功能。Objective:To report the phenomenon of reopening of the natural lacrimal duct in nine patients with chronic dacryocystitis long time after intranasal endoscopic dacryocystorhinostomy.Methods:275 patients (310 eyes) with chronic dacryocystitis underwent intranasal dacryocystorhinostomies under local or general anesthesia.The postoperative follow-up included nasal endoscopy,irrigation of lacrimal duct with saline and intranasal application of corticosteroid.Results:After 3～60 months following-up postoperatively,the cure rate was 75.3%.11.7% of cases were improved and no effects in 13.0% of cases.The total effective rate was 87.0%.Of these 275 cases(310 eyes),the ostiums in 9 cases (9 eyes) were closed by scarring,but irrigation of lacrimal duct showed that the saline flowed out of the natural nasal ostium.Conclusion:The obstruction of inferior part of the natural lacrimal duct was not completely irreversible.It can replay the role of drainage when the bypass was established and the inflammation of lacrimal mucosa was relieved after dacryocystorhinostomy.

关 键 词：鼻内镜 泪囊鼻腔造孔术 泪囊炎 鼻泪管 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]