鼻内镜鼻腔泪总管开放术治疗泪囊吻合口瘢痕闭锁

Intra-nasal dacryocys-torhinostomy under nasoscope for Treatment of Postoperative anastomotic scar atresia

目的 为慢性泪囊炎鼻腔泪囊吻合术后泪囊吻合口瘢痕闭锁病人提供一种简便易行、效果满意的手术治疗方法.方法 1.术前常规进行鼻内镜检查.2.对鼻内镜检查疑有鼻窦慢性炎性病变者,进行鼻窦CT检查.3.术前常规进行泪道脓性分泌物细菌培养+药敏试验.4.术前药物的临床应用.5.术前清除鼻窦慢性炎性病变.6.在鼻内镜下,切除原鼻腔泪囊吻合术后吻合口处的瘢痕组织;扩大原手术后的泪骨骨窗;将泪总管直接开放于鼻腔.7.术后泪道冲洗.8.术后药物的临床应用.9.鼻内镜下泪总管吻合口清创.结果 12例12眼慢性复发性泪囊炎病人,在施行鼻内镜鼻腔泪总管开放术后,均获得满意效果.术后随访6个月～4年无复发.结论 鼻内镜鼻腔泪总管开放术,是治疗慢性复发性泪囊炎的一种简便有效的方法.

Objective To provide a new procedure for anastomotic scar atresia caused after dacryocystorhinostomy for chronic dacryocystitis,this is a simple and easy-to-operate method,with less injuries but greater effects.Methods Endoscopic surgery for anastomotic scar after dacryocystorhinostomy,with direct nasal dacryocys-torhinostomy.Repeated irrigation of lacrimal passage with mixture of hormone and antibiotics.Results Good results were achieved in the 12 cases diagnosed as anastomotic atresia after dacryocystorhinostomy with endoscopic nasal dacryocys-torhinostomy.No cases have recurrence in the following-up period from 6 months to 4 years.Conclusion Endoscopic nasal dacryocys-torhinostomy is a simple but very effective method for the treatment of anastomotic scar atresia caused after dacryocystorhinostomy.