Paediatric powered endonasal dacryocystorhinostomy
Paediatric powered endonasal dacryocystorhinostomy
复制标题
儿科动力鼻内泪囊鼻腔吻合术
DOI：
10.1007/s00405-011-1605-z
复制
发表时间：
2011
影响因子：
2.6
通讯作者：
C. Lobo
中科院分区：
文献类型：
--
作者：
D. Al;C. Inkster;C. Lobo
泪囊鼻腔吻合术（DCR）适用于患有持续性鼻泪管阻塞（NLDO）的儿童。内窥镜鼻内DCR在成人和儿童中均已成功实施，成功率与外部DCR相似。本文旨在评价在地区综合医院接受鼻内镜下DCR的儿科患者的结局。回顾性分析了2001年10月至2008年12月期间在关节泪管诊所接受鼻内镜下DCR的所有患者。对16名2 ~ 14岁儿童（17只眼）进行了分析。主要的结局指标是症状的缓解。14例（82%）出现泪溢，有或无粘性。复发性泪囊炎3例。3例患者患有唐氏综合征。无手术并发症。在平均12个月的术后期间，除了一个病例外，所有病例的症状都有所改善。虽然60%的患者症状完全缓解，但其余患者的症状轻微。在那些有残留症状的人中，有两人患有唐氏综合症。鼻内DCR是治疗持续性NLDO儿童的一种安全有效的干预措施。无颅面异常的儿童成功率较高。在眼科和耳鼻喉科顾问医生的联合护理下，为这些患者提供最佳护理。
Dacryocystorhinostomy (DCR) is indicated in children with persistent nasolacrimal duct obstruction (NLDO). Endoscopic endonasal DCR has been successfully performed in both adults and children, with success rates similar to that of external DCR. This paper aims to evaluate the outcomes of paediatric patients undergoing endonasal endoscopic DCR at a district general hospital. A retrospective review of all patients attending a joint lacrimal clinic undergoing endonasal endoscopic DCR between October 2001 and December 2008 was performed. Sixteen children (17 eyes) aged between 2 and 14 were analysed. The main outcome measure was resolution of symptoms. Fourteen cases (82%) presented with epiphora with or without stickiness. Three cases had recurrent dacryocystitis. Three patients had Down syndrome. There were no operative complications. During a mean post-operative period of 12 months, all but one case showed an improvement of symptoms. While 60% of the patients had a complete resolution of symptoms, the remaining were minimally symptomatic. Of those with residual symptoms, two had Down syndrome. Endonasal DCR is a safe and effective intervention for children with persistent NLDO. Success is higher in children with no craniofacial abnormality. Joint care under a consultant Oculoplastic and ENT surgeon provides optimum care for these patients.