外路泪囊鼻腔吻合术是否将被淘汰

摘要

外路泪囊鼻腔吻合术(DCR)长期被认为是临床治疗鼻泪管阻塞和慢性泪囊炎的金方法.然而近年来随着鼻内镜外科技术在鼻眼相关疾病手术中的应用,鼻内镜下经鼻DCR取代外路DCR似乎成为一种趋势.鼻内镜下DCR的优点在于可避免皮肤切口瘢痕和可同时处理鼻部病变等,但是其存在长期成功率相对较低、对术者技术水平要求高、学习曲线长、手术设备昂贵、手术费用高等缺点.因此,应根据患者的病情和对手术的接受程度、术者的手术经验以及可利用的手术资源来合理选择手术方式.历经近百年实践检验的外路DCR仍然具有经鼻DCR不可比拟的优越性,应该得到广泛重视和应用.%External dacryocystorhinostomy (DCR) has long been considered as the gold standard treatment for nasolacrimal duct obstruction or chronic dacryocystitis.Recently,however,endoscopic endonasal DCR is becoming increasingly popular with the development of endoscopic surgery technique in naso-orbit related diseases.Endoscopic DCR has the advantages of avoiding an external incision scar and simultaneously handling with nasal conditions.Nevertheless,the new method also has some disadvantages,for example,the lower long-term success rate,the high technical requirement,long learning curves,expensive equipment and the high cost of surgery.The choice of the surgical approaches should be based on the patient's condition,experience of the surgeon and available resources.After nearly a century of proven,external DCR still has incomparable superiority and should receive widespread attention and application.