PDF(Pubmed)
Abstract：
UNASSIGNED: An understanding of the anatomical structure is crucial for completing successful endoscopic dacryocystorhinostomy (DCR) surgery. This study aimed to precisely delineate the spatial relationship between the lacrimal sac and the agger nasi cell (ANC) and evaluate the impact of ANC on surgical strategies in endoscopic DCR.
UNASSIGNED: This retrospective cross-sectional study included 110 Han Chinese patients diagnosed with unilateral primary acquired nasolacrimal duct obstruction (PANDO) from January 2021 to June 2023. This study was conducted in Eye, Ear, Nose, and Throat Hospital of Fudan University and involved inpatient participants who were scheduled for DCR surgery under general anesthesia. Patients were consecutively enrolled. The patients underwent preoperative computed tomography-dacryocystography (CT-DCG), and contrast-enhanced images were used to locate the positions of the lacrimal sac and the common canaliculus. A dynamic approach was adopted to analyze the multiplanar CT imaging, facilitating a detailed assessment of the morphology of the lacrimal drainage system and potential overlap of the lacrimal sac. Patient ages and measured values are presented as the mean ± standard deviation, which were measured three times by the same observer and averaged for statistical analysis.
UNASSIGNED: The prevalence of ANC in this study was 90.9% (100/110). Dynamic examination revealed that only 42.7% (47/110) of ANCs appeared as discrete cells, while the majority were connected to nearby sinus openings. Spatial analysis showed that in 57 out of 110 cases, ANCs were situated below the common canaliculus and not posterior to the lacrimal sac, indicating an overlap rate of 51.8%. Notably, our dynamic approach identified five critical cases of overlap below the level of the common canaliculus, which might have been missed by prior studies that used different methodologies.
UNASSIGNED: More than half of the ANCs exhibited overlap with the lacrimal sac, suggesting a significant proportion may necessitate opening during endoscopic DCR procedures. ANCs are often interconnected with adjacent nasal sinuses, necessitating careful consideration in the decision to open the ANCs during surgery. The dynamic evaluation employed in CT-DCG effectively assessed the extent of ANC coverage over the lacrimal sac.
UNASSIGNED: This retrospective cross-sectional study included 110 Han Chinese patients diagnosed with unilateral primary acquired nasolacrimal duct obstruction (PANDO) from January 2021 to June 2023. This study was conducted in Eye, Ear, Nose, and Throat Hospital of Fudan University and involved inpatient participants who were scheduled for DCR surgery under general anesthesia. Patients were consecutively enrolled. The patients underwent preoperative computed tomography-dacryocystography (CT-DCG), and contrast-enhanced images were used to locate the positions of the lacrimal sac and the common canaliculus. A dynamic approach was adopted to analyze the multiplanar CT imaging, facilitating a detailed assessment of the morphology of the lacrimal drainage system and potential overlap of the lacrimal sac. Patient ages and measured values are presented as the mean ± standard deviation, which were measured three times by the same observer and averaged for statistical analysis.
UNASSIGNED: The prevalence of ANC in this study was 90.9% (100/110). Dynamic examination revealed that only 42.7% (47/110) of ANCs appeared as discrete cells, while the majority were connected to nearby sinus openings. Spatial analysis showed that in 57 out of 110 cases, ANCs were situated below the common canaliculus and not posterior to the lacrimal sac, indicating an overlap rate of 51.8%. Notably, our dynamic approach identified five critical cases of overlap below the level of the common canaliculus, which might have been missed by prior studies that used different methodologies.
UNASSIGNED: More than half of the ANCs exhibited overlap with the lacrimal sac, suggesting a significant proportion may necessitate opening during endoscopic DCR procedures. ANCs are often interconnected with adjacent nasal sinuses, necessitating careful consideration in the decision to open the ANCs during surgery. The dynamic evaluation employed in CT-DCG effectively assessed the extent of ANC coverage over the lacrimal sac.
摘要：
■了解解剖结构对于成功完成内窥镜泪囊鼻腔造口术（DCR）手术至关重要。这项研究旨在精确描绘泪囊和aggernasi细胞（ANC）之间的空间关系，并评估ANC对内窥镜DCR手术策略的影响。
■这项回顾性横断面研究纳入了2021年1月至2023年6月诊断为单侧原发性获得性鼻泪管阻塞（PANDO）的110名中国汉族患者。这项研究是在眼睛中进行的，耳朵,鼻子,和复旦大学附属喉部医院，并参与了安排在全身麻醉下进行DCR手术的住院参与者。连续招募患者。患者术前接受计算机断层扫描-泪囊造影（CT-DCG），和对比增强图像用于定位泪囊和总泪小管的位置。采用动态方法对多平面CT成像进行分析,有助于详细评估泪道引流系统的形态和泪囊的潜在重叠。患者年龄和测量值表示为平均值±标准偏差，由同一观察者测量三次，并取平均值进行统计分析。
■本研究中ANC的患病率为90.9％（100/110）。动态检查显示，只有42.7％（47/110）的ANC表现为离散细胞，而大多数连接到附近的鼻窦开口。空间分析表明，在110例中的57例中，ANCs位于总泪小管下方，而不是泪囊后方，表明重叠率为51.8%。值得注意的是,我们的动态方法确定了五个关键的重叠病例，低于普通小管的水平，以前使用不同方法的研究可能错过了这一点。
■超过一半的ANC表现出与泪囊重叠，提示相当比例的患者可能需要在内窥镜DCR手术期间开放.ANCs通常与相邻的鼻窦相互连接，在决定在手术期间打开ANC时需要仔细考虑。CT-DCG中采用的动态评估有效地评估了泪囊上的ANC覆盖程度。
■这项回顾性横断面研究纳入了2021年1月至2023年6月诊断为单侧原发性获得性鼻泪管阻塞（PANDO）的110名中国汉族患者。这项研究是在眼睛中进行的，耳朵,鼻子,和复旦大学附属喉部医院，并参与了安排在全身麻醉下进行DCR手术的住院参与者。连续招募患者。患者术前接受计算机断层扫描-泪囊造影（CT-DCG），和对比增强图像用于定位泪囊和总泪小管的位置。采用动态方法对多平面CT成像进行分析,有助于详细评估泪道引流系统的形态和泪囊的潜在重叠。患者年龄和测量值表示为平均值±标准偏差，由同一观察者测量三次，并取平均值进行统计分析。
■本研究中ANC的患病率为90.9％（100/110）。动态检查显示，只有42.7％（47/110）的ANC表现为离散细胞，而大多数连接到附近的鼻窦开口。空间分析表明，在110例中的57例中，ANCs位于总泪小管下方，而不是泪囊后方，表明重叠率为51.8%。值得注意的是,我们的动态方法确定了五个关键的重叠病例，低于普通小管的水平，以前使用不同方法的研究可能错过了这一点。
■超过一半的ANC表现出与泪囊重叠，提示相当比例的患者可能需要在内窥镜DCR手术期间开放.ANCs通常与相邻的鼻窦相互连接，在决定在手术期间打开ANC时需要仔细考虑。CT-DCG中采用的动态评估有效地评估了泪囊上的ANC覆盖程度。
