PDF(Pubmed)
Abstract：
UNASSIGNED: The dacryocystorhinostomy (DCR) procedure is linked to a high success rate; however, cases of tearing recurrence are not rare and should be managed efficiently. Thus, evaluating cases of DCR failure allows highlighting the factors significantly impacting the results in order to realize better controlled primary surgeries.
UNASSIGNED: Twenty-eight patients were operated in our Otolaryngology Department for endoscopic revision of DCR failure between January 2019 and June 2022. Their clinical presentation, postoperative evolution, and findings of the primary and revision surgeries were assessed until the actual follow-up.
UNASSIGNED: The first surgery was based on an external approach in 17 patients and the bicanalicular silicone tube intubation was kept for a mean of 4.25 months. The recurrence delay varied from 0.5 to 9 months. Revision surgery revealed synechia in 10 patients, a completely closed DCR ostium in 22 patients (78.57%) by mucosal scarring and granulation, and lacrimal sac fibrosis in 16 patients (57.14%). A significant correlation was found between maintenance of the silicone intubation tube greater than or equal to 3 months and lacrimal sac fibrosis (P=0.016<0.05).
UNASSIGNED: Thus, better controlled primary surgeries with optimal exposure, wild marsupialisation of the lacrimal sac and no longer systematic bicanalicular intubation which should be dedicated to difficult anatomies and canalicular affections should guarantee better functional results.
UNASSIGNED: Twenty-eight patients were operated in our Otolaryngology Department for endoscopic revision of DCR failure between January 2019 and June 2022. Their clinical presentation, postoperative evolution, and findings of the primary and revision surgeries were assessed until the actual follow-up.
UNASSIGNED: The first surgery was based on an external approach in 17 patients and the bicanalicular silicone tube intubation was kept for a mean of 4.25 months. The recurrence delay varied from 0.5 to 9 months. Revision surgery revealed synechia in 10 patients, a completely closed DCR ostium in 22 patients (78.57%) by mucosal scarring and granulation, and lacrimal sac fibrosis in 16 patients (57.14%). A significant correlation was found between maintenance of the silicone intubation tube greater than or equal to 3 months and lacrimal sac fibrosis (P=0.016<0.05).
UNASSIGNED: Thus, better controlled primary surgeries with optimal exposure, wild marsupialisation of the lacrimal sac and no longer systematic bicanalicular intubation which should be dedicated to difficult anatomies and canalicular affections should guarantee better functional results.
摘要：
■泪囊鼻腔造口术（DCR）与高成功率有关；然而，撕裂性复发的病例并不罕见，应有效管理。因此，评估DCR失败的案例可以突出显着影响结果的因素，以实现更好的控制初级手术。
■在2019年1月至2022年6月期间，有28例患者在我们的耳鼻喉科进行了DCR失败的内窥镜翻修手术。他们的临床表现，术后进化，并对初次和修正手术的结果进行评估,直至实际随访.
■第一次手术是在17例患者的外部方法基础上进行的，双管硅胶管插管的平均时间为4.25个月。复发延迟从0.5到9个月不等。翻修手术显示10例患者粘连，通过粘膜瘢痕和肉芽形成，22例患者（78.57％）完全封闭的DCR口，泪囊纤维化16例(57.14%)。硅胶插管维持≥3个月与泪囊纤维化之间存在显著相关性(P=0.016<0.05)。
■因此，更好地控制初级手术，最佳暴露，泪囊的野生有袋化和不再系统的双管插管，应致力于困难的解剖和泪小管的影响，应保证更好的功能效果。
■在2019年1月至2022年6月期间，有28例患者在我们的耳鼻喉科进行了DCR失败的内窥镜翻修手术。他们的临床表现，术后进化，并对初次和修正手术的结果进行评估,直至实际随访.
■第一次手术是在17例患者的外部方法基础上进行的，双管硅胶管插管的平均时间为4.25个月。复发延迟从0.5到9个月不等。翻修手术显示10例患者粘连，通过粘膜瘢痕和肉芽形成，22例患者（78.57％）完全封闭的DCR口，泪囊纤维化16例(57.14%)。硅胶插管维持≥3个月与泪囊纤维化之间存在显著相关性(P=0.016<0.05)。
■因此，更好地控制初级手术，最佳暴露，泪囊的野生有袋化和不再系统的双管插管，应致力于困难的解剖和泪小管的影响，应保证更好的功能效果。
