BACKGROUND Nasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint,and it may derive from amyloidosis in rare cases.There are a few reports about localized amyloidosis,and amyloidosis wi...BACKGROUND Nasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint,and it may derive from amyloidosis in rare cases.There are a few reports about localized amyloidosis,and amyloidosis with involvement and obstruction of the nasolacrimal duct is exceedingly rare.CASE SUMMARY A 54-year-old male presented with a 2-year history of a lump overlying the left lacrimal sac that had grown rapidly for nearly half a year.Physical examination touched a firm lump in the left lacrimal sac.Nasal endoscopy discovered lesions in appearance of sediments with easy bleeding at the entry of the nasolacrimal duct of the left inferior nasal meatus.Computerized tomography scan revealed speckle high density in the left lacrimal sac and the dilated nasolacrimal duct.During an endoscopic exploration and excision,a large number of dacryoliths were exposed.Pathology indicated amorphous pink material and multinucleated giant cell reaction in the fibrous tissue.CONCLUSION This case showed amyloidosis in localized form mimicking dacryolith with nasolacrimal duct obstruction.In clinical practice,we should be aware of the possibility of localized amyloidosis in the nasolacrimal excretory system.展开更多
Background:Pediatric nasolacrimal duct obstruction (PNDO) requires therapeutic intervention after conservative procedures failed.As resilient treatment guidelines for the treatment are missing,the aim of this study wa...Background:Pediatric nasolacrimal duct obstruction (PNDO) requires therapeutic intervention after conservative procedures failed.As resilient treatment guidelines for the treatment are missing,the aim of this study was to evaluate the advantages of two different intervention techniques in children with PNDO.Methods:Between January,2006 and June,2014,233 children (0-208 months) were treated either with conventional probing by ophthalmologists only (Group I) or with endonasal endoscopic interdisciplinary approach (Group Ⅱ).The clinical outcome was analyzed.Results:The overall success rate of Group Ⅰ was 93.4% compared to 98.4% of Group Ⅱ (P<0.05).50% of all interventions (n=62) of Group Ⅱ required further surgical procedures in addition to probing/irrigation,particularly with regard to children <6 and >24 months.Conclusions:Endoscopic control in treatment of PNDO allows exact identification of the stenosis and appropriate surgical intervention with an improved clinical outcome.Endonasai endoscopic surgical techniques should be the standard PNDO treatment.展开更多
目的:比较内窥镜下球形头硅胶管插管(SHSI)与泪囊鼻腔吻合术(En-DCR)治疗鼻泪管阻塞(NLDO)的疗效与经济效益。方法:将43例50眼NLDO患者随机分为SHSI组(21例25眼)和En-DCR组(22例25眼),比较两组患者术中出血量、单眼手术时间、手术不适...目的:比较内窥镜下球形头硅胶管插管(SHSI)与泪囊鼻腔吻合术(En-DCR)治疗鼻泪管阻塞(NLDO)的疗效与经济效益。方法:将43例50眼NLDO患者随机分为SHSI组(21例25眼)和En-DCR组(22例25眼),比较两组患者术中出血量、单眼手术时间、手术不适及住院时间,随访至术后12mo,根据末次随访时溢泪与泪道灌洗情况评估临床疗效,并采用成本-效果比(C/E)进行经济效益评估。结果:SHSI组患者术中出血量与手术不适视觉模拟评分显著低于En-DCR组(4.96±1.989mL vs 27.60±14.950mL,2.84±0.64分vs 4.88±0.84分),单眼手术时间与住院时间显著短于En-DCR组(13.40±6.007min vs 59.64±12.786min,0.50±0.010h vs 137.280±23.085h)(均P<0.001)。末次随访时,两组患者临床有效率无差异(88%vs 96%,P>0.05),但SHSI组患者C/E(13.57)远小于En-DCR(121.50)。结论:内窥镜下SHSI与En-DCR均为NLDO的有效手术治疗方法,但SHSI手术难度相对更低且具有明显的成本效益优势。展开更多
基金The National Natural Science Foundation of China,No.61931013,No.61527807 and No.62041103Nanjing Medical Science and technique Development Foundation,No.QRX17207.
文摘BACKGROUND Nasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint,and it may derive from amyloidosis in rare cases.There are a few reports about localized amyloidosis,and amyloidosis with involvement and obstruction of the nasolacrimal duct is exceedingly rare.CASE SUMMARY A 54-year-old male presented with a 2-year history of a lump overlying the left lacrimal sac that had grown rapidly for nearly half a year.Physical examination touched a firm lump in the left lacrimal sac.Nasal endoscopy discovered lesions in appearance of sediments with easy bleeding at the entry of the nasolacrimal duct of the left inferior nasal meatus.Computerized tomography scan revealed speckle high density in the left lacrimal sac and the dilated nasolacrimal duct.During an endoscopic exploration and excision,a large number of dacryoliths were exposed.Pathology indicated amorphous pink material and multinucleated giant cell reaction in the fibrous tissue.CONCLUSION This case showed amyloidosis in localized form mimicking dacryolith with nasolacrimal duct obstruction.In clinical practice,we should be aware of the possibility of localized amyloidosis in the nasolacrimal excretory system.
文摘Background:Pediatric nasolacrimal duct obstruction (PNDO) requires therapeutic intervention after conservative procedures failed.As resilient treatment guidelines for the treatment are missing,the aim of this study was to evaluate the advantages of two different intervention techniques in children with PNDO.Methods:Between January,2006 and June,2014,233 children (0-208 months) were treated either with conventional probing by ophthalmologists only (Group I) or with endonasal endoscopic interdisciplinary approach (Group Ⅱ).The clinical outcome was analyzed.Results:The overall success rate of Group Ⅰ was 93.4% compared to 98.4% of Group Ⅱ (P<0.05).50% of all interventions (n=62) of Group Ⅱ required further surgical procedures in addition to probing/irrigation,particularly with regard to children <6 and >24 months.Conclusions:Endoscopic control in treatment of PNDO allows exact identification of the stenosis and appropriate surgical intervention with an improved clinical outcome.Endonasai endoscopic surgical techniques should be the standard PNDO treatment.
文摘目的:比较内窥镜下球形头硅胶管插管(SHSI)与泪囊鼻腔吻合术(En-DCR)治疗鼻泪管阻塞(NLDO)的疗效与经济效益。方法:将43例50眼NLDO患者随机分为SHSI组(21例25眼)和En-DCR组(22例25眼),比较两组患者术中出血量、单眼手术时间、手术不适及住院时间,随访至术后12mo,根据末次随访时溢泪与泪道灌洗情况评估临床疗效,并采用成本-效果比(C/E)进行经济效益评估。结果:SHSI组患者术中出血量与手术不适视觉模拟评分显著低于En-DCR组(4.96±1.989mL vs 27.60±14.950mL,2.84±0.64分vs 4.88±0.84分),单眼手术时间与住院时间显著短于En-DCR组(13.40±6.007min vs 59.64±12.786min,0.50±0.010h vs 137.280±23.085h)(均P<0.001)。末次随访时,两组患者临床有效率无差异(88%vs 96%,P>0.05),但SHSI组患者C/E(13.57)远小于En-DCR(121.50)。结论:内窥镜下SHSI与En-DCR均为NLDO的有效手术治疗方法,但SHSI手术难度相对更低且具有明显的成本效益优势。
