内镜下泪总管开放术治疗鼻内镜下泪囊鼻腔吻合术失败残留小泪囊的临床疗效

Clinical efficacy of endoscopic endonasal common canaliculorhinostomy for residual small lacrimal sac after failed endoscopic endonasal dacryocystorhinostomy

摘要:

目的 探讨经鼻内镜下泪总管开放术（EE-CAR）治疗鼻内镜下泪囊鼻腔吻合术（EE-DCR）失败患者的临床疗效，旨在提高EE-DCR失败患者再次手术的成功率。方法 选择2018年4月－2023年1月该院因泪囊鼻腔黏膜吻合口闭锁导致EE-DCR失败的患者44例（48眼），术前根据患者自愿原则分为两组。其中，A组（26眼）行EE-CAR，B组（22眼）单纯行经鼻内镜下吻合口切开术（EE-OO），比较两组患者术后疗效和并发症发生情况。结果 术后6个月随访，A组手术成功率为84.62%（22/26），明显高于B组的手术成功率54.55%（12/22），差异有统计学意义（P < 0.05）。结论 EE-CAR治疗吻合口闭锁所致泪囊残部小的EE-DCR术后失败患者，临床疗效明显优于EE-OO，值得临床推广应用。

Abstract:

Objective To explore the efficacy of treating patients with endoscopic endonasal dacryocystorhinostomy (EE-DCR) failure by endoscopic endonasal common canaliculorhinostomy (EE-CAR), in order to improve the success rate of reoperation in patients with EE-DCR failure.Methods 44 cases (48 eyes) patients with EE-DCR failure caused by lacrimal sac nasal mucosal ostium atresia from April 2018 to January 2023 were enrolled. They were divided into two groups according to the principle of voluntariness before surgery. Group A (26 eyes) underwent EE-CAR, group B (22 eyes) underwent endoscopic endonasal ostial openning (EE-OO). The postoperative efficacy and complications of the two groups was compared.Results Followed up at 6 months postoperative, the success rate of surgery was 84.62% (22/26) in group A, which was higher than 54.55% (12/22) in group B. There was significant difference between the two groups (P < 0.05).Conclusions EE-CAR is better than EE-OO in the treatment of patients with small lacrimal sac remnant after EE-DCR due to ostium atresia. It is worthy for clinical application.