改良式淚囊鼻腔吻合術

Modified Method of Dacryocystorhinostomy

劉正旺(Cheng-Wang Liu) ； 許紋銘(Wen-Ming Hsu)

《中華民國眼科醫學會會刊》 25卷1期 (1986/05) Pp. 71-75

https://doi.org/10.30048/ACTASOS.198605.0015

摘要

使用淚囊鼻腔吻合術來治療慢性淚囊炎之目的主要是在淚囊與鼻腔之間造成一永久性瘻管，然而由於縫合淚囊後葉與鼻腔黏膜後葉之不易，故一般手術法僅將淚囊前葉及鼻黏膜前葉予以縫合。本文報告使用單一鼻黏膜瓣縫合於淚囊後葉，而淚囊前葉則縫合於前淚嵴之骨膜上，不僅手術方法簡單而且成功率也高，術後並使用內視鏡來檢查吻合處癒合之情形，除教學作用之外並可照像在證。

並列摘要

Between March 1984 and October 1985, 15 patients were operated on 8, at 803 Army General Hospital 7 at VGH. Follow up periods ranged from 3 to 17 months. All patients had obstruction of the nasal lacrimal duct as evidenced by reflux of mucus on compression of the sac area, negative dye tests and complete obstruction on irrigation.
Our technique uses a single nasal mucosal flap reflected posteriorly and sutured to the posterior lacrimal sac flap, with the anterior lacrimal sac flap being sutured to the periosteum of the anterior lacrimal crest. A rubber catheter is inserted between the sutured anterior and posterior flaps as a stent.
14 of the 15 patients reported subjective improvement of their symptoms. Successful results were documented by a positive Jones I test, patent dacryocytography, lacrimal schintigraphy, and intral nasal examination of the anastomotic site. The only failed case still complained of epiphora which was due to damage of the canaculi during the operation.
The advantage of this technique is that in a restricted space the suture of a single nasal mucosal flap to the posterior lacrimal sac flap is easier than the use of double nasal mucosal flaps. The sutured flap of the anterior lacrimal sac to periosteum of the anterior lacrimal crest is quite strong. The procedure is simple, effective, and has a high success rate.

並列關鍵字

chronic dacryocystitis ； dacryocystorhinostomy ； anterior and posterior flaps suture ； intranasal endoscopy