泪液排泄障碍的术前及术后超声评价

Presurgical and postsurgical ultrasound assessment of lacrimal drainage dysfunction

In addition to the obligatory clinical tests, imaging of the lacrimal drainage system (LDS) is useful in its clinical evaluation. The purpose of this study wa s to examine the usability and reliability of ultrasonography in the evaluation of the lacrimal drainage system. Observational cohort study. A prospective study was conducted at a single institution. We performed ultrasound examinations on 17 patients with epiphora before and after surgery, and on 17 asymptomatic volun teers, to visualize and evaluate the anatomic and functional condition or pathol ogic abnormalities of the LDS.Echographic evaluation of the LDS was possible in all individuals. Pathologic abnormalities (canaliculitis, diverticulitis, concre tion, or dilation of the lacrimal sac, and reduced functionality of the orbicula r muscle and/or lacrimal sac pump) could be well demonstrated. In the postsurgic al course, functional patency of the dacryocystorhinostomy opening could be veri fied in all cases. Sonography of the LDS appears to represent a reliable diagnos tic technique supplementary to clinical tests in the presurgical and postsurgica l examination of patients with epiphora. Pathologic abnormalities that may not b e apparent in routine X ray dacryocystography can be demonstrated with ultrasou nd techniques. Patients also benefit from the avoidance of exposure to ionizing radiation. However, ultrasound is not suitable for imaging the lower part of the lacrimal sac and the lacrimal duct because of the presence of overlying bony st ructures.