Objective To explore the methods to localize nasal cut ends of lacerated lacrimal canaliculi in anasto-motic surgeries and to investigate the clinical applications of the localization methods. Methods From November 2008 to November 2010, a total of 80 eyes with tom eyelid and inferior lacrimal canalicular laceration were operated for anastomosis and circular tube placement. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi were tried. Silicone drainage tubes (Shandong Freda produce) guided by double probing needles were placed into the nasal cavity through the inferior and superior lacrimal punctum; then the probing needles were withdrawn, and the lacerated ends were knotted in the nasal cavity. Results After 3-6 months of indwelling, no epiphora was observed in syringing of lacrimal passages (SOLP) test in 68 cases. The lacrimal canaliculi were also patent in 4 cases with lacrimal punctum torn. There were 8 cases in which the canaliculi were obstructed. The patients were followed additional 6 months after extubation. In 61 cases, canaliculi appeared to be continuously patent. The overall successful rate was 76.3%. Conclusion The key of anastomosing surgery for the canalicular laceration is to search the nasal canalicular cut ends. The nasal canalicular cut ends can be localized through the combination of a variety methods in stage I anastomosis. This could improve the outcome and shorten the operation time.%目的 探讨泪小管断裂鼻侧断端的寻找方法及临床应用.方法 我院自2008年11月至2010年11月对80例(80只眼)眼睑裂伤伴下泪小管断裂的患者行吻合联合环形置管术,术中综合运用多种方法寻找到泪小管鼻侧断端,将双探针引导硅胶泪道引流管(山东正大福瑞达生产)分别自上、下泪小点,通过泪小管断端处进入鼻腔,将双探针从鼻腔勾出,并在鼻腔内打结,术中均能找到鼻侧断端并Ⅰ期吻合,提高手术成功率,缩短手术时间.结果 术后常规留置3～6个月,68例患者拔管后泪道冲洗均通畅,无溢泪现象；4例泪小点撕裂,冲洗尚通畅.8例术后泪道冲洗不通.拔管后随访6个月,61例冲洗通畅,无溢泪现象,总有效率76.3％.结论 泪小管断裂吻合术中,关键是寻找到泪小管鼻侧断端,综合运用多种方法均能Ⅰ期找到泪小管鼻侧断端.此手术方法疗效确切.
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