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Table of Content

    16 August 2009 Volume 23 Issue 4
      
    Articles
    Therapeutic effect of adenoidectomy by nasal endoscopy on infants with obstructive sleep apnea hypopnea syndrome
    WANG Ren-Xiang, XU Wei-Wei, YU Qiu-Gong, WANG Xiang-Yun, FU Gui-Qin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  6-7. 
    Abstract ( 1279 )   PDF (234KB) ( 1172 )   Save
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    Objective To explore the efect of adenoidectomy by endoscopy in treating obstructive apnea hypopnea syndrome(OSAHS) in infants. Methods  16 cases of OSAHS in infants were treated by adenoidectomy. All were diagnosed as adenoidal hypertrophy by X-ray. Operation was done under general anesthesia by endotracheal intubation.Results  Snoring and nasal obstruction disappeared. No recurrence was found in a follow-up of 6 to 12 months.Conclusion  Adenoidectomy by endoscopy is effective in infants with OSAHS.
     
    Serum C-reactive protein in children with sleep-disordered breathing before and after adenotonsillectomy
    WANG Yan, LI Yan-Zhong, WANG Xin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  8-11. 
    Abstract ( 1517 )   PDF (264KB) ( 1324 )   Save
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    Objective:To find the therapeutical effect of systemic inflammation in sleep disordered breathing(SDB) children after adnotonsillectomy. Methods:Polysomnography monitoring was performed in 65 snoring children all night and Conners concise questionnaire was applied to assess children′s behavior symptoms The change of serum C-reactive protein levels and improvement in abnormal behavior were compared in obstructive sleep apnea-hypopnea syndrome(OSAHS) childrenand primary snoring children before and 1 year after adnotonsillectomy. Results:The Conner′s concise  symptom questionnaire behavior score and serum C-reactiveprotein content of children with OSAHS were significantly higher than those of primary snoring children and healthy control children; and the two above indicators were also significantly higher in primary snoring children than in healthy control children. After adnotonsillectomy the score in Conners concise symptom questionnaire of OSAHS children was decreased form 14.2±3.8 to 6.7±3.1(P<0.05), and the serum C-reactive protein was decreased from (4.25±1.78)mg/L to(3.23±1.45)mg/L(P<0.05). The score of abnormal behavior in the primary snoring group was decreased from 9.4±4.1 to 5.1±2.8(P<0.05); the serumCreactive protein concentration fell from (2.77±1.80)mg/L to (1.76±0.81)mg/L(P<0.05). Conclusion:OSAHS and primary snoring children are  frequently associated with increases of CRP levels and a lot of behavior disorder problems,and those indicators and symptoms can become reversible after treatment by adnotonsillectomy.

    Thirty cases of severe OSAHS treated by combination of H-UPPP and low-temperature plasma of the soft palate and corpus linguae
    XU Zhen-Yue, FANG Ming-Da, HONG Bin, LI Zhao-Sheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  12-14. 
    Abstract ( 1845 )   PDF (302KB) ( 1054 )   Save
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    Objective To explore the feasibility, superiority and matters for attention of the modified H-UPPP combined with the treatment of low-temperatureplasma of the soft palate and corpus linguae for severe OSAHS.  Methods  30 casesof severe OSAHS with velo and tongue pharyngeal obstruction diagnosed by polysomnography and by Muller's maneuver were treated surgically by H-UPPP combinedwith treatment of the low-temperature plasma of the soft palate and corpus linguae. The uvula was preserved completely in the operation and the flat oropharyngeal civility was cut. All the patients accepted polysomnography before the operation, 6-month, 1-year and 3-year after the operation.  Results  The responses for 6-month, 1-year and 3-year were 100%, 83.33%, and 76.67% respectively. No case underwent tracheotomy during and after operation. No velopalatal insufficiency occurred. Conclusions The combined treatment of OSAHS is simple, safe and effective. It needs no tracheotomy and has less injury and rapid recovery. The treatment of CPAP is necessary before operation and the tracheacanula should be removed 24h after waking.

    Clinical analysis on 12 cases of nasal rhabdomyosarcoma
    LIN Xin, LIN Xin-Sheng, LIN Jia-Wei, YANG Chu, LI Chuang-Wei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  15-17. 
    Abstract ( 1692 )   PDF (324KB) ( 1195 )   Save
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    Objective To discuss the clinical character,diagnosis, treatment andprognosis of nasal rhabdomyosarcoma(RMS).   Methods  Integrated with a literaturereview, 12 cases of nasal rhabdomyosarcoma were analyzed retrospectively. The RMS originated from the nasal cavity, in 2 cases, maxillary sinus  in 3 cases, and ethmoid sinus  in 1 case, and 4 infiltrated into the maxillary sinus and ethmoidsinus in 4 cases. The primary site was not clear in 2 cases. 2 cases were treated only by operation, 8 by operation, radiotherapeutics and chemotherapeutics, 2 byradiotherapeutics and chemotherapeutics. 6 cases were treated by a nasal endoscopicsurgical procedure, 4 by lateral rhinotomy, and 5 by neck dissection at the same time. Results The survival rates for 1 and 3 years were 75.0%(9/12) and 33.3%(4/12) respectively. Recurrence was found in 7 cases within 1 year. Among them, 5 accepted  retrieval operation and 2 gave up treatment. Conclusions  The prognosisof RMS was bad, early diagnoses, wide surgical resection and integrated treatment could improve survival rate. Nasal endoscopic surgery could reduce operation trauma and has advantages especially for patients in the early stage.

    CT features of Schwannomas of the cervical sympathetic nerve correlated with  surgical findings
    LIU Bin, JIANG Yu-Ling, LIN Ji-Gao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  18-20. 
    Abstract ( 1605 )   PDF (336KB) ( 1274 )   Save
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    Objective To investigate the value of CT in the diagnosis of schwannomas of the  cervical sympathetic nerve (SSN) corrleated with surgical findings. Method Sixteen consecutive patients with schwannomas of the cervicalsympathetic nerve, proven by surgery and pathology,  were referred to computed tomography axialscanning. The CT findings for the location of masses, size, margin, contrast enhancement, and the rules of displacement of the common carotid artery, internal carotid artery and internal jugular vein were evaluated. Also the locations, characteristics of the lesions and rules of displacement of the common carotid artery, internal carotid artery and internal jugular vein were described with surgical correlation. Results 10 SSNs were located at the level of the commoncarotid bifurcation with the common carotid artery abutting against and displacing the lateral periphery of the tumor, and 16 SSNs with the internal carotid artery abutting against and displacing the lateral periphery of the tumor.  In 14 SSNs with enhanced CT, the internal jugular vein also abutted against and displaced the lateral periphery of the tumor. All the anatomical positional relationships among the commoncarotid artery, internal carotid artery and internal jugular vein with the cervicalsympathetic nerve were proved by operation. Conclusion CT axial scan can  accurately reflect the anatomical positional relationships among the common carotid artery, internal carotid artery and internal jugular vein with the cervical sympathetic nerve.

    Debridement for repeated epistaxis in patients with radiation-related nasopharyngeal necrosis
    ZHANG Jian-Li, WANG Yue-Jian, CHEN Wei-Xiong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  21-23. 
    Abstract ( 2507 )   PDF (247KB) ( 917 )   Save
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    Objective  To investigate the effect of debridement for repeated  epistaxis in patients with radiationrelated nasopharyngeal necrosis. Methods 8 cases of radiationrelated nasopharyngeal necrosis, which were admitted for repeated epistaxis, were treated with debridement. Results 7 cases werecured and 1 patient died of massive nasopharyngeal hemorrhage. Conclusions Forcases of radiation-related nasopharyngeal necrosis, if nasal packing can not control it, debridement may be an effective way.

    Clinical experience of no-insufflation endoscopic thyroidectomy by a small incision upon the sternum
    CHEN Wei-Xiong, WANG Yue-Jian, CENG Yong, HE Fa-Yao, ZHANG Jian-Li, ZHENG Li-Gang, TANG Su-Cheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  24-26. 
    Abstract ( 1568 )   PDF (273KB) ( 1079 )   Save
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    Objective To evaluate the cosmetic effect,application and safety of no-insufflation endoscopic thyroidectomy by a small incision upon the sternum. Methods  Based on the miccoli style, with the suspensory instrum ents designed by us and high frequency ultracision to incise and stanch, no-insufflation endoscopic  thyroidectomy by a small incision upon the sternum was performed in 51 patients of nodular goiter and 1 patient of Papillary thyroid carcinoma. ResultsAll operations were successfully carried out. No incision was widened for hemostasis duringor after the operation. The patient of Papillary thyroid carcinoma had temporary paralysis and no other complication happened in the recurrent laryngeal nerves. Conclusion No-insufflation endoscopic thyroidectomy by a small incision upon the sternum has the major advantages of small incision, less injury and quicker recovery,and it also has obvious postoperative cosmetic effect and creditable  safety. It is an ideal operation for thyroid patients.

    Anatomical study on rib composite flap pedicled with the internal thoracic artery and veins
    LI Ke-Yi, ZHANG Bin, LIU Zhi-Yu, YUAN Dao-Yang, NIU Fu-En, ZHANG Wei-Feng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  27-29. 
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    Objective To investigate the anatomical characteristics of the anterior chest wall blood-supply of internal thoracic artery and veins and their perforating branches. Methods The  distribution and  anastomosis of the internal thoracic artery and veins were observed on 4 anterior chest walls of 2 fresh adult cadaverswhich were infused by red and blue colorant. The  origin, course, branch, external diameter, distribution and  anastomosis of the internal thoracic artery andveins were observed on 30 anterior chest walls of 15 adult cadavers. The precise localization of the internal thoracic artery and its perforating branches were measured.  Results The majority of  perforating branches originated fromthe medial wall of theinternal thoracic artery. The second and third perforating branches were frequently seen; their incidence rates were 100%, and the antilinear was bigger. Therewere many anastomoses of perforating branches. There was only 1 or no perforating branch vein. The internal thoracic artery is the predominant blood-supply vesselof the anterior chest wall.  Conclusion Rib composite flap pedicled with internal thoracic artery and veins is an ideal material for the reconstruction of mandibular composite tissue defect.

    Shuxuetong injection in treatment of acute low-tone sensorineural hearing loss
    ZHANG Qiang-Quan, Wang-Jiang Chen-Xiu-Mei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  33-34. 
    Abstract ( 1514 )   PDF (242KB) ( 1112 )   Save
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    ObjectiveTo explore the curative effectof Shuxuetong Injection in treating acute lowtone sensorineural hearing loss(ALSHL) and the possible reasonfor ALSHL. Methods We performed detailed audiology tests and administered Shuxuetong Injection on 42 patients diagnosed as ALSHL, and the curative effects were observed. Results  Of 42 patients, 33 completely recovered their hearing(25 healed after one course of treatment, and 8 healed after two courses of treatment), and 9 patients partly recovered after two courses of treatment. The curative ratewas 78.57%, and effective rate was 100%. 3 patients who were cured suffered recurrences after 3 to 24 months and were retreated with Shuxuetong Injection. One of them was cured again while 2 partly recovered. One had a homolateral bombus and unsteadiness while walking, which disappeared after symptomatic treatments.Conclusions Based on the fact that all patients were in their middle or senile ages, and most had a drinking problem or emotional agitation before the onset, we estimate that the disease may be related to vascular factors and blood viscidity changes, and the satisfactory effect of Shuxuetong Injection also supports our estimation

    which is worthy of notice for therapists.

    Results and analysis of 6?159 newborn hearing screening
    ZHANG Dun-Yao, SHU Fu-Gao, SUN Mei-Gong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  38-40. 
    Abstract ( 1548 )   PDF (236KB) ( 1232 )   Save
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    Objective To investigate newborn hearing disorders and clinical feature by analyzing data of newborn hearing screening. Methods The screening had three phases and included 6?159 newborns from May 2006 to Jan. 2009 in ourhospital. In phaseⅠ, the staff of the delivery suit screened newborn by Distortion Product Otoacoustic Emissions (DPOAE) between the third day and the seventh day after birth, or before the time of discharge. In phase Ⅱ, those who failed in phaseⅠ had a hearing test by DPOAE after forty-two days. Newborns who failed the second test were referred to a specified hospital for phase Ⅲ.  Audiometrists tested their hearing by Diagnostic Otoacoustic Emission, Auditory Brainstem Response and 40Hz Auditory Event Related Potential. Results 5594 newborns  were tested in phaseⅠand 4?641 passed, with a passrate of 82.96%. 953 newborns needed a further test, but only 507 newborns were tested in phase Ⅱ, and 447passed , with a passrate of 88.17%. Thirteen newborns (6 males and 7 females) were diagnosed as having hearing disorders in phase Ⅲ. The prevalence of newborn hearing disorders was 2.53‰ in all newborns, 2.41‰ in males and 2.63‰ in females. The prevalence rate of males showed no significant difference compared with that of females (P>0.05). The prevalence of hearing disorders of newbornswhoexperienced treatments after birth in a neonatal intensive care unit (NICU) was12.35‰ (five cases), and that of those without the experience was 1.69‰ (eight cases), the former's prevalence increased significantly compared with that of the latter (P<0.05). Conclusion The prevalence of newborn hearing disorders between males and females has no significant difference. Newborns who have experience in NICU demonstrate a higher prevalence than those without the experience. Themethod of two phases hearing screening by DPOAE can increase the pass-rate of the hearing test.

    Effects of stimulus intensity on gap detection in the onset unit of the inferior colliculus in guinea pigs
    SU Kai-Meng, CHEN Zheng-Nong, GUAN Jian, XU Dong-Zhen, SHI Hai-Bei, YAN Shan-Kai
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  41-44. 
    Abstract ( 1239 )   PDF (360KB) ( 1088 )   Save
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    Objective To explore the effects of stimulus intensity on gap detection responses of onset neurons in inferior colliculus(IC) of guinea pigs.  Methods Gap stimuli were noise bursts, with levels from 10 to 80?dB SPL. A series of silent gaps including 0, 1, 2, 4, 8, 16, 48 and 96ms gap duration were embedded between the initial 100?ms white noise burst (NB1) and the final 50ms burst (NB2) in the stimuli. The minimal gap threshold (MGT), first spike latency (FSL) andNB2 recovery rate were also analyzed according to four intensity groups: minimum threshold (MT), MT+10dB SPL (MT+10), MT+20dB SPL(MT+20), and MT+30dB SPL(MT+30). ResultsThirtyfive onset units were collected from 96 recorded neurons. The average MGT was (22.91±4.36)ms, (9.00±2.69)ms, (4.00±0.49)ms and (11.33±3.11)ms in the groups of MT, MT+10, MT+20 and MT+30, respectively (P<0.01). However, this effect was not significant among the group of suprathreshold. The NB2recovery rate in 48ms gap duration was 0.44±0.15, 0.83±0.12, 0.88±0.07 and 0.61±0.10, respectively. The FSL in 0ms gap duration was (12.86±0.72)ms, (11.65±0.64)ms, (11.03±0.65)ms and (10.68±0.55)ms respectively in the four groups. ConclusionThe level of white noise gap stimuli has some effects on thegap response in the onset unit of inferior colliculus in guinea pigs.

    Curative effect of drugs on chronic rhinosinusitiswith smell disturbance
    LIU Ting-Ting, ZHANG Nian-Kai
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  45-47. 
    Abstract ( 1442 )   PDF (230KB) ( 1232 )   Save
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    Objective To observe the therapeutic effect of drugs on chronic rhinosinusitis with smell disturbance.  Methods  Twenty-six consecutive patients withchronic rhinosinusitis and smell disturbance,encountered between January 2006 and August 2008, were in cluded in this retrospective study. 20 were given Decongestant, Antiinflammatory, and anti-infection therapy and therapy promotingmucus to enduction. On the basic of the above therapy, 5 were given systemic steroids and neural nutrition,and 1 was given systemic steroids, neural nutrition and anti-virus therapy. Olfactory  test, CT in nasal sinus and nasal endoscope examination were given before and after the therapy. Results Among the 26cases, 24(92.00%), were cured; the average time of therapy was 25.64 days.  Conclusion  According to the  etiological factors,  suitable therapy can getsatisfactory therapeutic efficacy for smell disturbance which is the major symptomof chronic rhinosinusitis.

    Silica film in the correction of deviation of the nasal septum
    HAN Rong-Shi, XUE Jian-Jun, HUANG He, ZHANG Sheng-Jun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  48. 
    Abstract ( 1457 )   PDF (206KB) ( 1104 )   Save
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    Objective To study the effect of silica film in the correction of deviation of the nasal septum. Method  30 cases underwent correction. Of them, 15 cases used slica films and 15 did not. Result  In the silicone-chip  group, the mucosa of the nasal septum was smooth and flat and healed in 4.1 days on average without post-operative complications. While in the non-silicone film group, the mucosa had ulcers or erosion and ceusts and healed in 15.4 days on average. Followed up for 5 months to 1 year, no perforation was found. Conclusion  Silicone film has a moisturizing effect on the mucous membrane, also it can support and shape the septal mucosa, and it produces little pain for patients because of its softness.

    Sublingual immunotherapy on allergic rhinitis
    KUANG Jia-Li, TUN Jun, GUO Liang, FANG Xiang-Jia
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  49-51. 
    Abstract ( 2156 )   PDF (259KB) ( 1400 )   Save
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    Objective  To observe the effect of sublingual immunotherapy on allergic rhinitis.  Methods  A randomized, double-clind, parallel-controlled trial was conducted. 70 patients with allergic rhinitis whose test result was positive for dermatophagoides farinae were equally divided into two groups: the experimental group accepted sublingual immunotherapy, and the control group accepted desensitization therapy by regular subcutaneous injection. All patients were followed up fortwo years and the effect was evaluated.  Results  The response rate was 80.0% in the experimental group, and 77.1% in the control group. There was no statistical difference between the two groups(P>0.05). But the symptom score was statistically different after treatment in each group(P<0.01). Conclusion  Sublingual immunotherapy has almost the same good effectiveness as subcutaneous immunotherapy. Forits safety and convenience, it is worth populariz ing in practice.

    Impact of preoperative inhalation of Budesonide on recovery of polyps of the vocal cord
    YANG Ye, GAO Xia, CHEN Feng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  58. 
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    Objective  To study the impact of preoperative inhalation of Budesonide on recovery.  Methods  There were two kinds of patients. One consisted of patients withonset within three months and the other with onset more than one year. For eachkind, patients were divided into an experimental group and control group. Reexamination was made two weeks after surgery. The parameters of preliminary diagnosis, pre-operation and reexamination were recorded by acoustic testing machine  Results  The parameters of patients with onset within three months showed marked changes.  Conclusion  The preoperative Budesonide inhalation treatment can shorten the recovery period of patients with onset within three months.

    Treatment of 32 cases of injury in the larynx
    WANG Yong-Cai, WANG Shi-Zhen, WANG Xin-Ya
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  60-62. 
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    Objective  To investigate the type and treatment of injury ofthe larynx. Methods  The clinical data of 32 cases of injury in the larynx from 2004 to 2008 were retrospectively analyzed. Results  All had satisfactory results.Conclusion  Treatment of injury of the larynx should be performed based on different causes and clinical manifestations. 

    Phacoemulsification through a small pupil and  intraocular lens implantation
    HANG Chun-Jiu, SHU Xiao-Yu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  63. 
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    Objective  To discuss the surgical techniquesand attention points inphacoemulsification through a small pupil. Methods  Fifty-two eyes of  46  patients accepted  phacoemulsification by  using  non-cut  pupil  dilation  stop and  chop techniques.  Results  Cataract was emulsified in 47 of the 52 eyes and  the  pupil size recovered  to normal (2 to 3mm) after surgery.  In another 5 eyes,  the traction and expansion was performed after separation of synechia andexcision of the organized membranes, and pupils almost returned to round shape. The visual acuity 1 month after operation was≥0.5 in 38 eyes (73%). Conclusion  After  phacoemulsification  through a  small  pupil  by  non-cut pupildilation  method  the  pupil  can   recover  to  normal  and  the  visual  acuity  can be better recovered.

    Clinical application of Avastin in the surgery of  proliferative diabetic retinopathy
    SUN Xian-Yong, HUANG Xu-Dong, HUANG Jing, XU Xin-Pan, LOU Hua-Dong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  65-67. 
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    Objective  To evaluate the clinical effect of Avastin on vitrectomy for proliferative diabetic retinopathy(PDR). Methods  The clinicaldata were retrospectively analyzed in 32 eyes of 31 patients for PDR treated with an intravitreal  injection of 0.1mL/2.5mg Avastin 5-7 days before the operation, then a normal three-way vitrectomy was made on all the patients, and phacoemulsification and intraocular lens implantation were combined for 16 patients with cataract. Results  Originally active neovascularization decreased or ended, hemorrhage decreased in stripping and cutting the membrane, and stripping the membrane became easier than before. In a follow up of 3 months, visual acuity increased in 26 eyes(81.3%), was unchanged in 5 eyes(15.6%), and decreased in 1 eye(3.1%). No severe complications were found. Conclusion  Avastin can significantly makevitrectomy easy,reduce the risks of hemorrhage and improve visual acuity of patients, but the safety and availability need a long-term and large sample clinical observation.

    Artificial nasolacrimal duct for nasolacrimal duct obstruction
    ZHANG Yu-Huan, HAN Fang-Ju, LI Jin-Rong, CHEN Xuan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(4):  68. 
    Abstract ( 1783 )   PDF (277KB) ( 1313 )   Save
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    Objective  To observe the intraoperative techniques of interventionalprocedure using an artificial nasolacrimal duct and evaluate the effectiveness.Methods  32 cases (32 eyes) of nasolacrimal duct obstruction underwent artificial nasolacrimal duct. The nasolacrimal duct was dilated and the stent was  retrogradely placed.  Dacryocystography was performed before the operation. Results  Artificial nasolacrimal duct placement was technically successful in 30 eyes and the technical success rate was 93.8%(30/32). The response  rate was 100%(30/30)  sixmonths after operation.  Conclusion  Interventional artificial nasolacrimalduct placement is a safe, simple and effective method for the treatment of nasolacrimal duct obstruction.