Abstract：
OBJECTIVE: To compare the clinical outcomes of patients undergoing additional procedures in endoscopic endonasal dacryocystorhinostomy (End-DCR) surgery and discuss the factors affecting the success of End-DCR surgery in light of relevant literature.
METHODS: The study included 155 patients who underwent End-DCR surgery in our clinic due to epiphora. This was a prospective randomized, single-blind, controlled trial. Group I (control) included 54 patients who did not undergo silicone stent insertion or silver nitrate application, group II included 51 patients who underwent silicone stent insertion only, and group III included 50 patients who underwent silver nitrate application only. Statistical analysis was performed on follow-up data regarding anatomic and functional success rates.
RESULTS: Revision surgery was performed in 16 patients who developed persistent epiphora in the postoperative period, including 6 in group I, 7 in group II, and 3 in group III (P = .4). The most common reason for revision surgery was stenosis of the neo-ostium (n = 8), followed by granulation tissue formation (n = 5) and synechia formation (n = 3). Granuloma formation was the most common postoperative complication, and a significant difference was found among the groups with regard to granuloma formation (P = .04). At postoperative month 12, the functional success rate was estimated to be 88%, 86%, and 94%, and the anatomic success rate was estimated to be 94%, 92%, and 96% in groups I, II, and III, respectively, with no significant difference, found among the 3 groups with regard to both rates (P = .79 and P = .76, respectively).
CONCLUSIONS: The results indicated that stenting and silver nitrate application did not affect surgical success. Our preliminary results on silver nitrate cauterization showed that it is an effective, inexpensive, and practical method to reduce granulation formation in the postoperative period.
METHODS: The study included 155 patients who underwent End-DCR surgery in our clinic due to epiphora. This was a prospective randomized, single-blind, controlled trial. Group I (control) included 54 patients who did not undergo silicone stent insertion or silver nitrate application, group II included 51 patients who underwent silicone stent insertion only, and group III included 50 patients who underwent silver nitrate application only. Statistical analysis was performed on follow-up data regarding anatomic and functional success rates.
RESULTS: Revision surgery was performed in 16 patients who developed persistent epiphora in the postoperative period, including 6 in group I, 7 in group II, and 3 in group III (P = .4). The most common reason for revision surgery was stenosis of the neo-ostium (n = 8), followed by granulation tissue formation (n = 5) and synechia formation (n = 3). Granuloma formation was the most common postoperative complication, and a significant difference was found among the groups with regard to granuloma formation (P = .04). At postoperative month 12, the functional success rate was estimated to be 88%, 86%, and 94%, and the anatomic success rate was estimated to be 94%, 92%, and 96% in groups I, II, and III, respectively, with no significant difference, found among the 3 groups with regard to both rates (P = .79 and P = .76, respectively).
CONCLUSIONS: The results indicated that stenting and silver nitrate application did not affect surgical success. Our preliminary results on silver nitrate cauterization showed that it is an effective, inexpensive, and practical method to reduce granulation formation in the postoperative period.
摘要：
目的：比较鼻内镜下泪囊鼻腔吻合术(End-DCR)患者的临床疗效，并结合相关文献探讨影响End-DCR手术成功的因素。
方法：本研究纳入了155例因泪露而在我们诊所接受了终末期DCR手术的患者。这是一个前瞻性随机，单盲,对照试验。第I组（对照组）包括54例未进行硅胶支架插入或硝酸银应用的患者，II组包括仅接受硅胶支架插入的51例患者，第三组包括50例仅接受硝酸银应用的患者.对有关解剖和功能成功率的随访数据进行统计分析。
结果：对16例患者进行了翻修手术，这些患者在术后期间出现了持续性的溢唇，包括第一组的6个，第二组7，3组(P=4)。翻修手术的最常见原因是新孔狭窄（n=8），随后是肉芽组织形成(n=5)和粘连形成(n=3)。肉芽肿形成是术后最常见的并发症,在肉芽肿形成方面，各组之间存在显着差异（P=0.04）。术后12个月，功能成功率估计为88%，86%,94%,解剖成功率估计为94%，92%,第一组中有96%，II,III,分别,没有显著差异，在3组中发现了这两种比率（分别为P=0.79和P=0.76）。
结论：结果表明，支架置入和硝酸银应用并不影响手术成功率。我们对硝酸银烧灼的初步结果表明，这是一种有效的，便宜,减少术后肉芽形成的实用方法。
方法：本研究纳入了155例因泪露而在我们诊所接受了终末期DCR手术的患者。这是一个前瞻性随机，单盲,对照试验。第I组（对照组）包括54例未进行硅胶支架插入或硝酸银应用的患者，II组包括仅接受硅胶支架插入的51例患者，第三组包括50例仅接受硝酸银应用的患者.对有关解剖和功能成功率的随访数据进行统计分析。
结果：对16例患者进行了翻修手术，这些患者在术后期间出现了持续性的溢唇，包括第一组的6个，第二组7，3组(P=4)。翻修手术的最常见原因是新孔狭窄（n=8），随后是肉芽组织形成(n=5)和粘连形成(n=3)。肉芽肿形成是术后最常见的并发症,在肉芽肿形成方面，各组之间存在显着差异（P=0.04）。术后12个月，功能成功率估计为88%，86%,94%,解剖成功率估计为94%，92%,第一组中有96%，II,III,分别,没有显著差异，在3组中发现了这两种比率（分别为P=0.79和P=0.76）。
结论：结果表明，支架置入和硝酸银应用并不影响手术成功率。我们对硝酸银烧灼的初步结果表明，这是一种有效的，便宜,减少术后肉芽形成的实用方法。
