ENDONASAL LASER DACRYOCYSTORHINOSTOMY - A NEW APPROACH TO NASOLACRIMAL DUCT OBSTRUCTION
ENDONASAL LASER DACRYOCYSTORHINOSTOMY - A NEW APPROACH TO NASOLACRIMAL DUCT OBSTRUCTION
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DOI：
10.1001/archopht.1990.01070100128048
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发表时间：
1990-08-01
影响因子：
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通讯作者：
HARRIS, GJ
中科院分区：
文献类型：
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作者：
MASSARO, BM;GONNERING, RS;HARRIS, GJ
使用耦合到300 μ m石英光纤导管的高功率氩蓝-绿激光器在新鲜冷冻尸体头部中产生鼻内泪囊鼻腔吻合瘘。该程序，我们长期鼻内激光泪囊鼻腔吻合术，描述。术后检查尸体标本。发现激光鼻造口术涉及泪囊窝的后下部。瘘管周围的组织未显示出损伤迹象。我们报告第一个病人接受鼻内激光泪囊鼻腔吻合术治疗鼻泪管阻塞，随访10个月。我们认为鼻内激光泪囊鼻腔吻合术比标准的外部泪囊鼻腔吻合术具有以下优点：（1）组织损伤仅限于离散的瘘管部位。(2)消除了外部解剖的皮肤疤痕和美容缺陷。(3)止血效果良好。(4)最小的手术和术后发病率允许门诊手术，更快地恢复正常的日常活动和提高成本效益。(5)患者更喜欢鼻内激光泪囊鼻腔吻合术而不是外部泪囊鼻腔吻合术。
A high-powered argon blue-green laser coupled to a 300-.mu.m quartz fiberoptic catheter was used to create intranasal dacryocystorhinostomy fistula in fresh-frozen cadaver heads. The procedure, which we term endonasal laser dacryocystorhinostomy, is described. Cadaver specimens were examined postoperatively. Laser rhinostomies were found to involve the posteroinferior portion of the lacrimal sac fossa. Tissues surrounding the fistula site showed no signs of damage. We report on the first patient to undergo endonasal laser dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction, with 10 months of follow-up. We believe endonasal laser dacryocystorhinostomy offers the following advantages over standard external dacryocystorhinostomy: (1) Tissue injury is limited to the discrete fistula site. (2) The cutaneous scar and cosmetic blemish of an external dissection are eliminated. (3) Excellent hemostasis is maintained. (4) Minimal operative and postoperative morbidity permits outpatient surgery, with faster resumption of normal daily activities and increased cost-effectiveness. (5) Patients prefer endonasal laser dacryocystorhinostomy to external dacryocystorhinostomy.