山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (6): 26-28.doi: 10.6040/j.issn.1673-3770.0.2015.210

• 论著 • 上一篇    下一篇

泪囊在鼻内镜泪囊鼻腔造口术中的解剖学研究及临床应用

王刚1, 胡金旺1, 陶伟2, 吴长松1, 卫平存1   

  1. 1. 安徽省第二人民医院耳鼻咽喉头颈外科, 安徽 合肥 230041;
    2. 安徽理工大学解剖学教研室, 安徽 淮南 232000
  • 收稿日期:2015-06-01 出版日期:2015-12-16 发布日期:2015-12-16
  • 通讯作者: 胡金旺.E-mail:enthjw@163.com E-mail:enthjw@163.com
  • 作者简介:王刚. E-mail:entwanggang@126.com

Anatomy of lacrimal sac to endoscopic transnasal dacryocystorhinostomy

WANG Gang1, HU Jinwang1, TAO Wei2, WU Changsong1, WEI Pingcun1   

  1. 1. Department of Otolaryngology & Head and Neck Surgery, Anhui Second Provincial Pepole's Hospital, Hefei 230041, Anhui, China;
    2. Department of Anatomy, Anhui University of Science & Technology, Huainan 232000, Anhui, China
  • Received:2015-06-01 Online:2015-12-16 Published:2015-12-16

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摘要： 目的 探讨经鼻内镜泪囊鼻腔造口术中泪囊在鼻腔外侧壁的解剖学定位.方法 对12具(24侧)成人尸头的泪囊在鼻腔外侧壁上的投影位置进行解剖学测量,为62例(85侧)慢性泪囊炎鼻泪管阻塞患者行经鼻内镜鼻腔泪囊造口术.结果 解剖学测量结果提示,15侧(62.5%)泪囊上界位于中鼻甲腋上方,9侧(37.5%)泪囊上界位于中鼻甲腋下方.临床结果:62例(85侧)术后随访6个月以上,治愈50例(70侧,82.3% ),好转8例(9侧,10.6%),无效4例(6侧,7.1%),总有效率为92.9%.结论 以中鼻甲腋前上0.7 cm为上界,腋前下0.3 cm为下界,钩突前缘向上延线为泪囊后界定位泪囊进行鼻腔泪囊造口为较佳选择.

关键词: 内窥镜检查, 解剖, 泪囊炎, 泪囊鼻腔造口术

Abstract: Objective To provide anatomical localization for endoscopic transnasal dacryocystorhinostomy. Methods Twelve adult cadavers(24 sides) were studied on the projection anatomy of lacrimal sac on the lateral wall of nasal cavity. Sixty-two patients (85 sides) with chronic dacryocystitis and nasolacrimal duct obstruction were treated by endoscopic transnasal dacryocystorhinostomy. Results Fifteen adult cadavers sides (62.5%) lacrimal sac upper bound were higher than the insertion of middle turbinate, 9 adult cadavers sides (37.5%) lacrimal sac upper bound were lower than the insertion of middle turbinate. During a post-operative follow-up of 6 months, 50 patients (70 sides 82.3%) were cured, 8 (9 sides 10.6%) had improvement, and 4 (6 sides 7.1%) were invalid. The total efficiency was 92.9%. Conclusion Upper bound of the lacrimal sac was 0.7 cm up the insertion of middle turbinate .Lower bound of the lacrimal sac was 0.3 cm under the insertion of middle turbinate. After bound of the lacrimal sacs was front of the uncinate.

Key words: Endoscopy;, Anatomy, Dacryocystorhinostomy, Dacryocystitis

中图分类号: 

  • R779.6
[1] Woog J J, Meston R, Puliafito C A.Holmium YAG endonasal laser dacryocystorhinostomy[J]. Am J Opthalmol, 1993, 116:1-10.
[2] Wormald P J, Kew J, Hasselt A V. Intranasal anatomy of the nasocrimal sac in endoscopic dac ryocystorhinostomy[J]. OtolaryngolHead Neck Surg, 2000, 123(3):307-310.
[3] 张速勤, 贾沛靓, 唐海红, 等. 泪囊鼻内解剖研究及临床应用[J].中华耳鼻咽喉头颈外科杂志, 2006,41(7): 506-509. ZHANG Suqin, JIA Peiliang, TANG Haihong, et al. Endonasal anatomy of lacrimal sac and its clinical significance in dacryocystorhinostomy[J]. Chin J Otolaryngol Head Neck Surgery, 2006, 41(7): 506-509.
[4] Olver J M. The success rates for endonasal dacryocystorhinostomy[J].Br J Ophthalmol, 2003, 87(11):1431-1433.
[5] Rice D H. Endoscopic intranasal dacryocystorhinostomy: A cadaver study[J]. Am J Rhinol, 1988, 2:127.
[6] 周兵.鼻内窥镜下鼻内泪囊鼻腔造孔术(附35例疗效分析) [J]. 耳鼻咽喉-头颈外科,1994,1(2):80-83. ZHOU Bing. Endoscopic intranasal dacryocystorhinostomy: a clinical analysis of 35 cases[J]. Chin Arch Otolaryngol Head Neck Surgery, 1994, 1(2):80-83.
[7] 马敬, 张小春, 徐学海, 等. 鼻内窥镜下泪囊鼻腔电钻造孔术[J]. 耳鼻咽喉-头颈外科,2002,9(1):60. MA Jing, ZHANG Xiaochun, XU Xuehai, et al. Endoscopic intranasal dacryocystorhinostomy with the electrodrill[J]. Chin Arch Otolaryngol Head Neck Surgery, 2002, 9(1):60.
[8] 韩德民,周兵. 鼻内窥镜外科学[M]. 北京:人民卫生出版社,2001:151.
[9] 贾沛靓, 张速勤, 唐海红, 等.鼻腔泪囊造口术的泪囊鼻内解剖研究[J].临床耳鼻咽喉科杂志,1999,20(8):344-346. JIA Peiliang, ZHANG Suqin, TANG Haihong, et al.Endonasal anatomy of lacrimal sac to endoscopic transnasal dacryocystorhinostomy[J]. Clin J Otolaryngol, 1999, 20(8):344-346.
[10] Orhan M, Saylam C Y, Midilli R. Intranasal Localization of the Lacrimal Sac [J]. Arch Otolaryngol Head Neck Surg, 2009, 135(8):764-770.
[11] 刘成,卫平存,胡金旺. 三种药物在泪囊鼻腔吻合术中的应用比较[J].山东大学耳鼻喉眼学报,2011,25(6):58-61. LIU Cheng, WEI Pingcun, HU Jinwang. Three kinds of medicine in dacryocystorhinostomy[J]. J Otolaryngol Ophthalmol Shandong Univ, 2011, 25(6):58-61.
[12] 范伟,王天怡, 邓爱军. 5-氟尿嘧啶与丝裂霉素C在改良外路泪囊鼻腔吻合术中的应用疗效比较[J].山东大学耳鼻喉眼学报,2014,28(5):99-100, 104. FAN Wei, WANG Tianyi, DENG Aijun. Application of 5-fluorouracil and mitomycin C in improved external dacryocystorhinostomy[J]. J Otolaryngol Ophthalmol Shandong Univ, 2014, 28(5):99-100, 104.
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