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Antegrade balloon dilatation of nasolacrimal duct obstruction in adults

机译:成人鼻泪管阻塞的整体球囊扩张

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摘要

AIMS—To determine the efficacy of antegrade balloon dilatation of postsaccal lacrimal stenosis in adults.
METHODS—Balloon dilatation was performed in a series of 30 patients with complete nasolacrimal duct obstructions and epiphora. Obstruction was diagnosed by canalicular irrigation and transcanalicular endoscopic examination of the lacrimal pathway. Except for four cases in which general anaesthesia was applied, the procedure was performed under local anaesthesia. The Lacricath balloon catheter set was used. Silicone intubation was performed simultaneously. The time at which the tubes were removed depended on the findings at postoperative follow up but was, at the earliest, 3 months postoperatively.
RESULTS—Success was objectified by irrigation and was evaluated subjectively at each follow up examination according to Munk's scale. In all cases the procedure could be performed with subsequent silicone intubation. Three months postoperatively 89.9% of all cases were positive on simple irrigation, and subjective success was also registered (Munk's grade 0 or 1). At 6 months 70% of all cases were positive on irrigation, again with subjective success (Munk's grade 0 or 1). One year postoperatively 73.3% of all procedures showed subjective success (two successful redilatations would raise the success rate to 79.9%).
CONCLUSION—Retrograde as well as antegrade dilatation has been reported to be more or less successful in partial nasolacrimal obstruction. Although the procedure is used as primary treatment in cases of complete obstruction, it can still be performed under local anaesthesia on an outpatient basis. Long term observation will be required to prove the sustained effect of this procedure.

机译:目的:确定成人椎弓根泪道狭窄的顺行性球囊扩张术的疗效。
方法:对30例具有完全鼻泪管阻塞和泪溢的患者进行了气球扩张术。通过泪小管冲洗和经泪小管内镜检查诊断为梗阻。除四例采用全身麻醉外,该手术均在局部麻醉下进行。使用了Lacricath球囊导管套件。同时进行硅胶插管。取管的时间取决于术后随访的发现,但最早要在术后3个月。
结果—成功的原因是通过冲洗进行客观检查,并在每次随访检查中根据Munk的主观评价规模。在所有情况下,都可以在随后的硅胶插管中执行该程序。术后三个月,所有病例中89.9%的患者在单纯冲洗中均呈阳性,并且也取得了主观成功(Munk的0级或1级)。在6个月时,所有病例中有70%的灌溉结果为阳性,再次获得主观成功(Munk的0级或1级)。术后一年的所有手术中,有73.3%的患者显示主观成功(两次成功的重新手术将成功率提高到79.9%)。
结论—据报道,逆行和顺行扩张或多或少在部分鼻泪道阻塞中获得成功。 。尽管该程序在完全梗阻的情况下用作主要治疗方法,但仍可以在门诊的局部麻醉下进行。需要长期观察以证明该程序的持续效果。

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