山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (5): 149-155.doi: 10.6040/j.issn.1673-3770.0.2022.223

• 综述 • 上一篇    

鼻内镜泪囊鼻腔吻合术预后影响因素的研究进展

刘楠1,2,逄明杰1   

  1. 1.青岛市市立医院 耳鼻咽喉头颈外科, 山东 青岛 266000;
    2.大连医科大学 研究生院, 辽宁 大连 116044
  • 发布日期:2023-10-13
  • 通讯作者: 逄明杰. E-mail:pangmingjie@sina.com
  • 基金资助:
    青岛市医疗卫生优秀人才培养项目(V市DTR2020Y15)

Review of factors influencing the prognosis of endoscopic dacryocystorhinostomy

LIU Nan1,2, PANG Mingjie1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Qingdao Municipal Hospital, Qingdao 266000, Shandong, China2.Graduate School of Dalian Medical University, Dalian 116044, Liaoning, China
  • Published:2023-10-13

PDF (PC)

89

摘要： 随着鼻内镜技术在鼻眼相关外科的不断发展与应用,鼻内镜泪囊鼻腔吻合术因较高的手术安全性及成功率,目前已成为治疗慢性泪囊炎的主要手术方法。手术原理主要是在泪囊和鼻腔之间建立新的泪液引流通道,鼻腔吻合口的粘连、狭窄及闭锁是导致该手术失败的重要原因。术前患者的鼻腔鼻窦病变情况可影响吻合口的正常上皮化,不同的手术操作方法及术后管理也会在一定程度上影响手术治疗效果,论文就影响鼻内镜泪囊鼻腔吻合术预后的相关因素进行综述,旨在为提高手术预后及临床诊治提供参考。

关键词: 鼻内镜泪囊鼻腔吻合术, 预后, 影响因素, 手术疗效, 慢性泪囊炎

Abstract: Following the development and application of nasal endoscopic technology in nasal-eye related diseases, endoscopic dacryocystorhinostomy has become the main surgical method for treatment of chronic dacryocystitis due to it high surgical safety and success rate. Basically, the procedure creates a new tear drainage channel between the lacrimal sac and the nasal cavity. Synechiae, stenosis, and cicatricial closure of the ostium are the most common causes of failure for this procedure. Normal epithelialization of the anastomosis can be affected by the preoperative nasal cavity and paranasal sinus lesions of the patient, and different surgical methods and postoperative management can also affect the outcomes of surgical treatment to a certain extent. In this study, we review the factors related to the prognosis of endoscopic dacryocystorhinostomy, aiming to provide a reference to improve the prognosis and clinical management of this procedure.

Key words: Endoscopic dacryocystorhinostomy, Prognosis, Influencing factors, Surgical efficacy, Chronic dacryocystitis

中图分类号: 

  • R765.9
[1] 陈祥雷. 慢性泪囊炎的临床治疗进展[J]. 国际眼科杂志, 2018, 18(4): 656-659. doi: 10.3980/j.issn.1672-5123.2018.4.15
[2] Marcet MM, Kuk AKT, Phelps PO. Evidence-based review of surgical practices in endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction and other new indications[J]. Curr Opin Ophthalmol, 2014, 25(5): 443-448. doi:10.1097/ICU.0000000000000084
[3] Nomura K, Arakawa K, Sugawara M, et al. Factors influencing endoscopic dacryocystorhinostomy outcome[J]. Eur Arch Otorhinolaryngol, 2017, 274(7): 2773-2777. doi:10.1007/s00405-017-4541-8
[4] Mak ST, Io IYF, Wong ACM. Prognostic factors for outcome of endoscopic dacryocystorhinostomy in patients with primary acquired nasolacrimal duct obstruction[J]. Graefes Arch Clin Exp Ophthalmol, 2013, 251(5): 1361-1367. doi:10.1007/s00417-012-2228-9
[5] 王庆, 刘小琴. 鼻内镜下鼻腔泪囊吻合失败原因分析及预防措施[J]. 中外医学研究, 2016, 14(27): 122-123. doi:10.14033/j.cnki.cfmr.2016.27.064 WANG Qing, LIU Xiaoqin. The analysis of failure reasons and prevention measures for transnasal endoscopic dacryocystorhinostomy[J]. Chinese and Foreign Medical Research, 2016, 14(27): 122-123. doi:10.14033/j.cnki.cfmr.2016.27.064
[6] Tessler I, Warman M, Amos I, et al. Endoscopic dacryocystorhinostomy among the old and oldest-old populations-A case control study[J]. Auris Nasus Larynx, 2021, 48(5): 898-904. doi:10.1016/j.anl.2021.02.010
[7] Keren S, Abergel A, Manor A, et al. Endoscopic dacryocystorhinostomy: reasons for failure[J]. Eye(Lond), 2020, 34(5): 948-953. doi:10.1038/s41433-019-0612-y
[8] 陈丽云, 吕岫葳, 师秀娟, 等. 鼻内镜下鼻腔泪囊吻合术后出血的原因分析及改进措施[J]. 护理研究, 2020, 34(7): 1269-1271. doi: 10.12102/j.issn.1009-6493.2020.07.036 CHEN Liyun, LYU Xiuwei, SHI Xiujuan, et al. Causes analysis and improvement measures of postoperative bleeding in patients with nasal lacrimal anastomosis by nasal endoscope[J]. Chinese Nursing Research, 2020, 34(7): 1269-1271. doi: 10.12102/j.issn.1009-6493.2020.07.036
[9] Atkova EL, Astrakhantsev AF, Fedorov AA, et al. The nasal mucosa and outcomes of dacryocystorhinostomy[J]. Arkh Patol, 2019, 81(2): 24-28. doi:10.17116/patol20198102124
[10] 白亚亚, 贺经, 杜青卫. 慢性泪囊炎的病理学研究进展[J]. 国际眼科杂志, 2020, 20(12): 2092-2095. doi: 10.3980/j.issn.1672-5123.2020.12.16 BAI Yaya, HE Jing, DU Qingwei. Research progress on pathology of chronic dacryocystitis[J]. International Eye Science, 2020, 20(12): 2092-2095. doi: 10.3980/j.issn.1672-5123.2020.12.16
[11] Smirnov G, Pirinen R, Tuomilehto H, et al. Strong expression of HSP47 in metaplastic nasal mucosa may predict a poor outcome after primary endoscopic dacryocystorhinostomy: a prospective study[J]. Acta Ophthalmol, 2011, 89(2): 132-136. doi:10.1111/j.1755-3768.2009.01654.x
[12] Park J, Lee J, Baek S. Pathologic features and expression of heat shock protein 47 in the nasal mucosa and lacrimal sac: does it influence the surgical outcome of endoscopic endonasal dacryocystorhinostomy? [J]. Eye, 2018, 32(9): 1432-1439. doi:10.1038/s41433-018-0115-2
[13] Altin Ekin M, Karadeniz Ugurlu S, Aytogan H, et al. Failure in revision dacryocystorhinostomy: a study of surgical technique and etiology[J]. J Craniofac Surg, 2020, 31(1): 193-196. doi:10.1097/SCS.0000000000005829
[14] Bakshi S. Feasibility of endoscopic dacryocystorhinostomy in patients with coexistent atrophic rhinitis and chronic dacryocystitis[J]. Int J Heal Allied Sci, 2019, 8: 83-86. doi:10.4103/ijhas.IJHAS_1_18
[15] 罗宝珍, 陈波蓓, 项海杰, 等. 鼻用激素-明胶海绵治疗鼻内镜术后鼻腔粘连[J]. 中国耳鼻咽喉头颈外科, 2017, 24(2): 95-98. doi:10.16066/j.1672-7002.2017.02.012 LUO Baozhen, CHEN Bobei, XIANG Haijie, et al. Efficacy of intranasal corticosteroids-gelatin sponge in the treatment of nasal adhesion after nasal endoscopic sinus surgery[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(2): 95-98. doi:10.16066/j.1672-7002.2017.02.012
[16] Jafari A, Lehmann AE, Shen SA, et al. Infection after endoscopic dacryocystorhinostomy: incidence and implications[J]. Am J Rhinol Allergy, 2021, 35(3): 375-382. doi:10.1177/1945892420958905
[17] 苏锐锋, 赵敏, 卢姗姗, 等. Lund-Mackay评分预测慢性泪囊炎合并慢性鼻窦炎同期手术疗效的作用[J]. 国际眼科杂志, 2020, 20(6): 1087-1090. doi: 10.3980/j.issn.1672-5123.2020.6.36 SU Ruifeng, ZHAO Min, LU Shanshan, et al. The value of Lund-Mackay score in predicting the effect of simultaneous surgery of chronic dacryocystitis with chronic sinusitis[J]. International Eye Science, 2020, 20(6): 1087-1090. doi: 10.3980/j.issn.1672-5123.2020.6.36
[18] 张懿, 杨华, 杨晓钊, 等. 鼻中隔偏曲对鼻腔内窥镜下泪囊鼻腔吻合术疗效的影响[J]. 国际眼科杂志, 2021, 21(1): 174-177. doi: 10.3980/j.issn.1672-5123.2021.1.36 ZHANG Yi, YANG Hua, YANG Xiaozhao, et al. Effect of nasal septum deviation on the curative effect of endonasal endoscopic dacryocystorhinostomy[J]. International Eye Science, 2021, 21(1): 174-177. doi: 10.3980/j.issn.1672-5123.2021.1.36
[19] Yang JW, Oh HN. Success rate and complications of endonasal dacryocystorhinostomy with unciformectomy[J]. Graefes Arch Clin Exp Ophthalmol, 2012, 250(10): 1509-1513. doi:10.1007/s00417-012-1992-x
[20] 陈新军, 王向东, 王月, 等. 泪囊窝与毗邻结构解剖关系的CT影像学研究[J]. 中国耳鼻咽喉头颈外科, 2020, 27(2): 67-70. doi:10.16066/j.1672-7002.2020.02.003 CHEN Xinjun, WANG Xiangdong, WANG Yue, et al. CT imaging study of anatomical relationship between lacrimal sac Fossa and adjacent structures[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2020, 27(2): 67-70. doi:10.16066/j.1672-7002.2020.02.003
[21] 张文彬, 丁芝祥, 廖妙云, 等. 经鼻内窥镜下鼻腔泪囊吻合术治疗泪囊炎疗效的影响因素分析[J]. 国际眼科杂志, 2020, 20(9): 1637-1640. doi: 10.3980/j.issn.1672-5123.2020.9.35 ZHANG Wenbin, DING Zhixiang, LIAO Miaoyun, et al. Analysis of influencing factors of curative effect of dacryocystorhinostomy with nasal endoscope in patients with dacryocystitis[J]. International Eye Science, 2020, 20(9): 1637-1640. doi: 10.3980/j.issn.1672-5123.2020.9.35
[22] Huang SE, Geng CL, Wang M, et al. Endoscopic dacryocystorhinostomy for refractory nasolacrimal duct obstruction with a small lacrimal sac(≤ 5 mm in diameter)[J]. Eur Arch Otorhinolaryngol, 2022, 279(10): 5025-5032. doi:10.1007/s00405-022-07347-1
[23] Yu B, Qian ZB, Han XM, et al. Endoscopic endonasal dacryocystorhinostomy with a novel lacrimal ostium stent in chronic dacryocystitis cases with small lacrimal sac[J]. J Craniofac Surg, 2020, 31(5): 1348-1352. doi:10.1097/SCS.0000000000006359
[24] 李沙, 陈琳, 刘兵, 等. 鼻腔泪囊吻合术中填充美乐胶治疗小泪囊泪囊炎[J]. 国际眼科杂志, 2019, 19(9): 1615-1618. doi: 10.3980/j.issn.1672-5123.2019.9.41 LI Sha, CHEN Lin, LIU Bing, et al. Clinical efficacy of MeroGel in the treatment of dacryocystitis with small dacryocyst[J]. International Eye Science, 2019, 19(9): 1615-1618. doi: 10.3980/j.issn.1672-5123.2019.9.41
[25] van Tassel SH, Segal KL, Hsu NM, et al. Endoscopic dacryocystorhinostomy following radioactive iodine thyroid ablation[J]. Orbit, 2017, 36(2): 59-63. doi:10.1080/01676830.2017.1279653
[26] 赵雅铭, 张维天, 李寅, 等. 内镜下泪囊鼻腔吻合术与经典开放术式的疗效对比[J]. 山东大学耳鼻喉眼学报, 2014, 28(4): 46-48, 51. doi: 10.6040/j.issn.1673-3770.0.2014.060 ZHAO Yaming, ZHANG Weitian, LI Yin, et al. Comparison of curative effect of endoscopic endonasal dacryocystorhinostomy with open surgery[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2014, 28(4): 46-48, 51. doi: 10.6040/j.issn.1673-3770.0.2014.060
[27] 邸斌, 吴彦桥, 李军, 等. 影像导航技术在鼻及颅底和鼻眼相关疾病内镜手术中的应用[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 25-30. doi: 10.6040/j.issn.1673-3770.0.2017.086 DI Bin, WU Yanqiao, LI Jun, et al. The clinical application of image-guided endoscopic technique in the management of nasal sinus, skull base and orbital disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(2): 25-30. doi: 10.6040/j.issn.1673-3770.0.2017.086
[28] 沈秀广, 秦蕊, 陆颖丽. 两种鼻黏膜切口在鼻内镜下鼻腔泪囊吻合术中的应用[J]. 国际眼科杂志, 2019, 19(6): 1072-1074. doi: 10.3980/j.issn.1672-5123.2019.6.41 SHEN Xiuguang, QIN Rui, LU Yingli. Application of two kinds of nasal mucosal incision in dacryocystorhinostomy under nasal endoscope[J]. International Eye Science, 2019, 19(6): 1072-1074. doi: 10.3980/j.issn.1672-5123.2019.6.41
[29] 中华医学会眼科学分会眼整形眼眶病学组. 中国内镜泪囊鼻腔吻合术治疗慢性泪囊炎专家共识(2020年)[J]. 中华眼科杂志, 2020, 56(11): 820-823. doi: 10.3760/cma.j.cn112142-20200515-00331
[30] Peng WY, Tan BW, Wang YD, et al. A modified preserved nasal and lacrimal flap technique in endoscopic dacryocystorhinostomy[J]. Sci Rep, 2017, 7(1): 6809. doi:10.1038/s41598-017-07364-9
[31] 倪天宇, 李淑珍, 郭龙, 等. 保留鼻黏膜瓣的鼻内镜泪囊鼻腔吻合术治疗慢性泪囊炎的效果研究[J]. 现代医药卫生, 2021, 37(15): 2614-2616. doi: 10.3969/j.issn.1009-5519.2021.15.023
[32] Zloto O, Koval T, Yakirevich A, et al. Endoscopic dacryocystorhinostomy with and without mucosal flap-is there any difference? [J]. Eye(Lond), 2020, 34(8): 1449-1453. doi:10.1038/s41433-019-0716-4
[33] Kingdom TT, Barham HP, Durairaj VD. Long-term outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation[J]. Laryngoscope, 2020, 130(1): 12-17. doi:10.1002/lary.27989
[34] 王永波, 赵雁之, 高扬, 等. 改良鼻内镜下泪囊鼻腔吻合术治疗慢性泪囊炎[J]. 国际眼科杂志, 2020, 20(5): 901-903. doi: 10.3980/j.issn.1672-5123.2020.5.36 WANG Yongbo, ZHAO Yanzhi, GAO Yang, et al. Clinical effect of improved endoscopic dacryocystorhinostomy for chronic dacryocystitis[J]. International Eye Science, 2020, 20(5): 901-903. doi: 10.3980/j.issn.1672-5123.2020.5.36
[35] 周吉超, 倪薇, 刘海华, 等. 透明质酸钠在经鼻内镜泪囊鼻腔吻合术中的应用[J]. 中国微创外科杂志, 2018, 18(2): 143-147. doi: 10.3969/j.issn.1009-6604.2018.02.014 ZHOU Jichao, NI Wei, LIU Haihua, et al. Application of sodium hyaluronate in endoscopic dacryocystorhinostomy[J]. Chinese Journal of Minimally Invasive Surgery, 2018, 18(2): 143-147. doi: 10.3969/j.issn.1009-6604.2018.02.014
[36] 徐景利, 吴雨潇, 王旻, 等. 鼻内镜泪囊鼻腔吻合术中泪囊黏膜后位切口的临床应用价值[J]. 中国耳鼻咽喉头颈外科, 2020, 27(2): 59-62. doi:10.16066/j.1672-7002.2020.02.001 XU Jingli, WU Yuxiao, WANG Min, et al. Significance of posterior lacrimal sac incision during endonasal endoscopic dacryocystorhinosotomy[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2020, 27(2): 59-62. doi:10.16066/j.1672-7002.2020.02.001
[37] Dinc ME, Ulusoy S, Sahin E, et al. The use of an ostial stent does not increase the success rate of endoscopic dacryocystorhinostomy[J]. J Laryngol Otol, 2018, 132(8): 718-723. doi:10.1017/S002221511800107X
[38] Atkova EL, Fedorov AA, Root AO, et al. Causes of unsatisfactory results of the use of mitomycin-C in endoscopic endonasal dacryocystorhinostomy[J]. Saudi J Ophthalmol, 2017, 31(3): 150-155. doi:10.1016/j.sjopt.2017.05.007
[39] Park J, Lee J, Jang S, et al. Effectiveness of sodium hyaluronate(Protad)application in endoscopic endonasal dacryocystorhinostomy[J]. Can J Ophthalmol, 2017, 52(2): 192-197. doi:10.1016/j.jcjo.2016.08.010
[40] 苏锐锋, 齐智伟, 张琦, 等. 三种填塞材料在鼻内镜下鼻腔泪囊吻合术中的应用[J]. 河北医科大学学报, 2021, 42(11): 1294-1297. doi: 10.3969/j.issn.1007-3205.2021.11.011 SU Ruifeng, QI Zhiwei, ZHANG Qi, et al. Application of three packing materials in endoscopic dacryocystorhinostomy[J]. Journal of Hebei Medical University, 2021, 42(11): 1294-1297. doi: 10.3969/j.issn.1007-3205.2021.11.011
[41] 屈爱红. 鼻内镜联合复方妥布霉素眼液治疗慢性泪囊炎疗效观察[J]. 临床合理用药杂志, 2019, 12(16): 92-93. doi:10.15887/j.cnki.13-1389/r.2019.16.051
[42] 李沙, 陈琳, 张咏, 等. 内镜下鼻腔泪囊吻合术疗效的影响因素分析[J]. 国际眼科杂志, 2020, 20(3): 547-550. doi: 10.3980/j.issn.1672-5123.2020.3.33 LI Sha, CHEN Lin, ZHANG Yong, et al. Analysis of the influencing factors of endoscopic dacryocystorhinostomy[J]. International Eye Science, 2020, 20(3): 547-550. doi: 10.3980/j.issn.1672-5123.2020.3.33
[43] Liu CM, Kohanski MA, Mendiola M, et al. Impact of saline irrigation and topical corticosteroids on the postsurgical sinonasal microbiota[J]. Int Forum Allergy Rhinol, 2015, 5(3): 185-190. doi:10.1002/alr.21467
[44] 王永波, 钱筱英, 鲍锡柳, 等. 鼻内镜下鼻腔泪囊造口术治疗泪囊炎常见失败原因[J]. 当代医学, 2017, 23(29): 155-157. doi: 10.3969/j.issn.1009-4393.2017.29.079
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