Objective: To explore the importance of an accurate interpretation ofhelical CT-dacryocystography before endoscopic dacryocystorhinostomy and its surgical technique for the treatment of traumatic dacryocystitis. Methods: This was a retrospective study. Analysis of 13 patients (14 eyes) who underwent nasal endoscopic dacryocystorhinostomy in the Second Hospital of Jilin University from April 2016 to March 2019 and included medical history, preoperative helical CT-dacryocystography and intraoperative conditions. According to whether the patient's symptoms improved, whether lacrimal tract irrigation was unobstructed, and whether the dacryocystorhinostomy was open, follow-up was performed for 6 months to evaluate the effect of surgery. Results: Through accurate CT readings, 3 eyes were found to have lacrimal sac displacement (one of which combined with lacrimalbone fracture), 6 eyes had amaxillary frontal process and nasal bone fracture (one of which had scar tissue proliferating between fractures), and the remaining 5 eyes only had nasolacrimal duct fractures, no obvious abnormalities in their positions and the local anatomy of the lacrimal sac. All 14 eyes were successfully treated with endoscopic dacryocystorhinostomy. Treatment for one of the eyes was combined with alacrimal sac nasal drainage stent due to the displacement of the lacrimal sac. Twelve patients (13 eyes) were cured, one patient (one eye) was notcured. Bleeding was easily controlled during the operation. There were no complications occurring after the operation, and no recurrence after at least 6 months of follow-up. Conclusions: Endoscopic dacryocystorhinostomy for the treatment of traumatic dacryocystitis is safe and effective, with few complications. An accurate preoperative reading of the helical CT-dacryocystography is helpful for accurate positioning and complete exposure of the lacrimal sac, which helps the endoscopic dacryocystorhinostomy go smoothly.
Chen X, Liu Y. Efficacy of nasal endoscopic dacryocystorhinostomy for chronic dacryocystitis: A systematic review protocol of randomized controlled trial. Medicine (Baltimore), 2019, 98(12): e14889. DOI: 10.1097/MD.0000000000014889.
[3]
Ci?er E, Balci MK, Arslano?lu S, et al. Endoscopic-powered dacryocystorhinostomy without stenting: Long-term outcomes of 120 procedures. Am J Rhinol Allergy, 2018, 32(4): 303-309. DOI: 10.1177/1945892418773638.
Wu W, Cannon PS, Yan W, et al. Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis. Eye (Lond), 2011, 25(6): 746-753. DOI: 10.1038/eye.2011.44.
Green R, Gohil R, Ross P. Mucosal and lacrimal flaps for endonasal dacryocystorhinostomy: A systematic review. Clin Otolaryngol, 2017, 42(3): 514-520. DOI: 10.1111/coa.12754.
[9]
Herzallah IR, Marglani OA, Muathen SH, et al. Endoscopic and radiologic findings in failed dacryocystorhinostomy: Teaching pearls for success. Am J Rhinol Allergy, 2019, 33(3): 247-255. DOI: 10.1177/1945892418815044.
[10]
Unlu HH, Gunhan K, Baser EF, et al. Long-term results in endoscopic dacryocystorhinostomy: Is intubation really required? Otolaryngol Head Neck Surg, 2009, 140(4): 589-595. DOI: 10.1016/j.otohns.2008.12.056.
[11]
韩德民, 张罗. 内镜鼻窦外科学. 2版, 北京: 人民卫生出版社, 2010: 7-13.
[12]
Wu W, Yan W, MacCallum JK, et al. Primary treatment of acute dacryocystitis by endoscopic dacryocystorhinostomy with silicone intubation guided by a soft probe. Ophthalmology, 2009, 116(1): 116-122. DOI: 10.1016/j.ophtha.2008.09.041.
[13]
Kamal S, Ali MJ, Pujari A, et al. Primary powered endoscopic dacryocystorhinostomy in the setting of acute dacryocystitis and lacrimal abscess. Ophthalmic Plast Reconstr Surg, 2015, 31(4): 293-295. DOI: 10.1097/IOP.0000000000000309.
[14]
Chisty N, Singh M, Ali MJ, et al. Long-term outcomes of powered endoscopic dacryocystorhinostomy in acute dacryocystitis. Laryngoscope, 2016, 126(3): 551-553. DOI: 10.1002/lary.25380.