慢性泪囊炎经鼻内窥镜下行钬激光泪囊鼻腔造孔术

Holmium Endonasal Laser Dacryocystorhinostomy

目的:探讨经鼻内窥镜下行钬激光泪囊鼻腔造孔术治疗慢性泪囊炎的应用。方法:应用钬激光技术于鼻内窥镜下治疗慢性泪囊炎47例(47只眼),术后随访3—6个月。结果:拔管后患者无流脓、泪溢;或无流脓,但泪溢症状改善,泪道冲洗通畅,鼻内窥镜下可见造空口成型定义为手术成功。成功率为93.6%。结论:应用鼻内窥镜下治疗慢性泪囊炎已成为鼻眼相关外科学的重要内容之一,我院近年来应用钬激光技术于鼻内窥镜下行泪囊鼻腔造孔术治疗慢性泪囊炎及泪囊鼻腔吻合手术失败的患者。该手术无面部瘢痕,术中于鼻内窥镜下用光导纤维通过泪道作准确定位后,应用钬激光技术具有止血作用,组织损伤小,方便快捷,泪液的导流系统不受影响,更是传统的泪囊鼻腔吻合手术失败的很好的补救方法。术毕置入与造孔口相匹配的硅胶条3月,并作定期随访,提高了手术的成功率。

Objective： To evaluate techniques of endonasal holmium laser-assisted dacryocystorhinostomy. Methods： Holmium endonasl laser dacryocystorhinostomy in 47 patients from August 2001 through March 2007. Postoperative follow-up interval ranged from three months to six months. Results： The success rate was 93.6%. The failure rate was 6.4%, Conclusions： With the development of the Holmium laser, a device is now available that offers those features necessary for effective dacryo- cystorhinostomy： precise bone ablation, efficient soft tissue coagulation, and fiberoptic transmission. Then, Laser surgery offers improved intraoperative hemostasis, and avoided a cutaneous scar. Holmium endoscopic instrumention allowed correction of intranasal causes of dcryocystorhinostomy failure.