泪囊鼻腔吻合术的体会——Toti手术百年纪念

The experience of dacryocystorhinostomy(DCR)—century memory for Toti surgery

目的 探讨经典的泪囊鼻腔吻合术双瓣缝合手术方式的远期效果。方法 于 1993年 8月～ 2 0 0 3年 7月对 116例( 116眼 )慢性泪囊炎进行经典的泪囊鼻腔吻合术 ,即泪囊和鼻黏膜“工”字形切开 ,前后叶分别相对缝合的术式。术后随访 2～6年 (平均 3 1年 )观察远期效果。结果 116例 116眼中治愈 112眼 ,占 96 5 5 % ;有效 4眼 ,占 3 45 %。无失败的病例。结论 Toti于 190 4年所创始的泪囊鼻腔吻合术 ,以及稍后改进的Mosher—Toti手术等术式 ,即“工”字双瓣吻合术 ,仍是泪道再通术中最可靠的方法。虽然操作较为复杂 ,初学者吻合后叶会有些困难 ,但其远期效果达 10 0 % ,较后来各种简化的术式为佳。

Objective To study the long-term effect of the classic DCR.Methods Between Aug.1993 and July 2003,116 cases (116 eyes) of chronic dacryocystitis received classic DCR.The lacrimal sac and nasal mucosa were incised in “工” shape and both the anterior and posterior flaps were sutured separately.The follow up time was 2～6 years (averaged 3 years).Results In the 116 eyes,112 were cured (96.55% ) and improved in 4 eyes (3.45 % ).Conclusion In 1904,Toti crented DCR and was modified as Mosher-Toti surgery and so on.Though these methods are complicated and exist some difficult when anastomosing the posterior flaps for a novice,the results is most reliable and success rate can reach 100%.