■这项前瞻性观察性研究旨在通过检查泪囊造影(DCG)图像来探索先天性鼻泪管阻塞(CNLDO)患者泪道形态的多样性。
■该研究包括64例患者,这些患者在接受单侧CNLDO的全身麻醉探查之前接受了DCG。从DCG图像的侧视图测量了几个参数:(1)泪囊(LS)和鼻泪管(NLD)角度,(2)上轨道边缘(SOR)形成的角度,LS,还有NLD,(3)LS长度,和(4)骨NLD长度。此外,DCG图像的正面视图用于测量(5)LS-NLD角和(6)关于中线的LS角。
■患者的平均年龄为34.3个月。上述参数测量的平均值±标准偏差为(1)-1.2°±16.5°(范围:-44.6°±46.6°),(2)-5.0°±10.3°(范围:-24.0°±19.0°),(3)10.2±2.4mm(范围:6.5-16.0mm),(4)8.0±2.5mm(范围:3.1-14.8mm),(5)15.6°±11.2°(范围:-16.8°±41.0°),(6)15.1±5.2°(范围:3.3°-29.8°)。所有参数,除参数(3)外,符合正态分布。
■这项研究提供了来自DCG图像的有价值的人体测量数据,强调CNLDO患者泪道形态的实质性变异性。此外,解剖学上的限制使得在本研究中25.0%的患者中,使用直金属探查在解剖学上不可行。
了解泪道的形态对于先天性鼻泪管阻塞(CNLDO)患者的成功探查治疗至关重要。这项研究代表了通过泪囊造影图像量化泪道引流系统人体测量参数的初步努力,专门旨在突出盲检程序的局限性。结果强调了患者泪道引流系统形态的显着差异,这可能会影响诊断方法和治疗策略。此外,研究结果表明,对盲检无反应的CNLDO患者可能存在潜在的解剖学复杂性.因此,而不是依靠重复的盲目探测,对于复杂的CNLDO病例,采用直视下的神经内镜引导探查可以提供更有效的治疗选择.
UNASSIGNED: This prospective observational study aimed to explore the diversity in lacrimal pathway morphology among patients with congenital nasolacrimal duct obstruction (CNLDO) by examining dacryocystography (DCG) images.
UNASSIGNED: The study included 64 patients who underwent DCG before undergoing general anesthesia probing for unilateral CNLDO. Several parameters were measured from the lateral view of the DCG images: (1) the lacrimal sac (LS) and the nasolacrimal duct (NLD) angle, (2) the angle formed by the superior orbital rim (SOR), LS, and the NLD, (3) LS length, and (4) bony NLD length. Additionally, frontal views of the DCG images were utilized to measure (5) LS-NLD angle and (6) LS angle concerning the midline.
UNASSIGNED: The average age of the patients was 34.3 months. The mean ± standard deviation of the measurements of the above parameters was (1) -1.2° ± 16.5° (range: -44.6° ± 46.6°), (2) -5.0° ± 10.3° (range: -24.0° ± 19.0°), (3) 10.2 ± 2.4 mm (range: 6.5-16.0 mm), (4) 8.0 ± 2.5 mm (range: 3.1-14.8 mm), (5) 15.6° ± 11.2° (range: -16.8° ± 41.0°), and (6) 15.1 ± 5.2° (range: 3.3°-29.8°). All parameters, except for parameter (3), conformed to a normal distribution.
UNASSIGNED: This study provides valuable anthropometric data derived from DCG images, highlighting the substantial variability in lacrimal pathway morphology among patients with CNLDO. Furthermore, anatomical constraints made probing with a straight metal bougie anatomically infeasible in 25.0% of the patients included in this study.
Understanding the morphology of the lacrimal pathway is crucial for the successful probing treatments in patients with congenital nasolacrimal duct obstruction (CNLDO). This study represents an initial effort to quantify anthropometric parameters of the lacrimal drainage system through dacryocystography images, specifically aiming to highlight the limitations of blind probing procedure. The results underscore significant variations in the morphology of the lacrimal drainage system among patients, which could impact diagnostic approaches and treatment strategies. Additionally, the findings suggest that patients with CNLDO who do not respond to blind probing may have underlying anatomical complexities. Therefore, rather than relying on repeated blind probing, employing dacryoendoscopy-guided probing under direct visualization could offer a more effective therapeutic alternative for complicated cases of CNLDO.