鼻内镜下鼻腔泪囊吻合术及部分联合泪道置管106例临床疗效分析

Endoscopic dacryocystorhinostomy or combined with lacrimal duct catheterization: a clinical analysis of 106 cases

目的探讨鼻内镜下鼻腔泪囊吻合术在慢性泪囊炎患者中的应用及疗效分析。方法回顾性分析2010年1月~2017年12月于烟台毓璜顶医院耳鼻咽喉头颈外科行手术治疗的106例慢性泪囊炎患者,根据泪囊形态,行鼻内镜下鼻腔泪囊吻合术66例,鼻腔泪囊吻合术联合泪道置管40例,术后均行3~6个月随访,观察术腔恢复及泪道通畅情况。结果 66例患者术中见泪囊较大,泪囊壁薄,无肉芽增生者行鼻内镜下鼻腔泪囊吻合术,62例泪道引流通畅,4例术后复发,治愈率93.9%;40例患者术中见泪囊较小,壁厚,有肉芽增生,给予鼻内镜下鼻腔泪囊吻合术联合泪道置管,37例泪道引流通畅,3例术后复发,治愈率92.5%。结论慢性泪囊炎患者行鼻内镜下鼻腔泪囊吻合术中根据泪囊形态,必要时联合泪道置管可取得满意疗效。

Objective To evaluate the application and treatment effects of endoscopic nasolacrimal dacryocystorhinostomy. Methods A retrospective array analysis was made of the clinical data of 106 patients with chronic dacryocystitis who underwent surgery from January 2010 to December 2017 in the Department of Otolaryngology Head and Neck, Yuhuangding Hospital of Yantai. Sixty-six patients underwent endoscopic nasolacrimal dacryocystorhinostomy and forty patients underwent nasolacrimal dacryocystorhinostomy combined with lacrimal duct catheterizations according to the shapes of the lacrimal sacs. All patients were followed up for 3-6 months to observe the recovery of nasal cavity and lacrimal passage patency. Results Sixty-six patients with large lacrimal sacs with thin walls and no granulation hyperplasia underwent endoscopic nasolacrimal dacryocystorhinostomy. Sixty-two out of sixty-six recovered smooth drainage of lacrimal passages, and four reported recurrence after the operations, with a cure rate of 93.9%. Forty patients with small lacrimal sacs, thick walls and granulation hyperplasia underwent nasal endoscopic dacryocystorhinostomy combined with lacrimal duct catherizations;thirty-seven out of forty cases recovered with smooth drainage of lacrimal passage, and three patients reported recurrence after the surgeries, with the cure rate being 92.5%. Conclusions Patients with chronic dacryocystitis undergoing nasal endoscopic dacryocystorhinostomy may need extra lacrimal duct catheterizations according to the shapes of their lacrimal sacs if necessary to achieve satisfactory effects.