尽管vidian神经切除术(VN)与流泪减少有关,其对干眼生活质量的影响尚不明确。鼻内镜下经翼状骨法(EETA)可能需要处死翼管神经。
一项前瞻性队列试验。
进行了一项前瞻性试验,通过酚红线测试评估EETA期间的VN对流泪的影响,并通过五项干眼问卷(DEQ-5)评估干眼严重程度。保留对侧vidian神经可以在术后接受VN的眼睛和对照眼睛之间进行比较。
21名受试者入选,术前在眼睛(P=.617)和总体轻度干眼严重程度之间的流泪没有差异。尽管对照眼在术前和术后泪液没有差异,1个月时VN眼中的撕裂减少(20.8mmvs.15.8mm,P=.015)和3个月时(23.2mmvs.15.8mm,P=.0051)术后。总的来说,术前和术后的干眼严重程度DEQ-5评分无差异.然而,6例患者术后出现中度至重度干眼症,其中5例患者术前流泪减少(<20mm).与正常流泪患者相比,术前流泪减少的患者术后DEQ-5评分明显更差(P<.0056)。
EETA期间的VN导致流泪减少,但与总体干眼严重程度增加无关。然而,术前泪液减少的患者存在干眼严重程度增加的风险,应针对这种风险进行咨询.
2喉镜,131:1487-1491,2021年。
Although vidian neurectomy (VN) is associated with decreased
lacrimation, its impact on dry eye quality-of-life is not well-defined. Endoscopic endonasal transpterygoid approaches (EETA) may require vidian nerve sacrifice.
A prospective cohort trial.
A prospective trial evaluating VN during EETA on
lacrimation by phenol red thread testing and dry eye severity by the five-item Dry Eye Questionnaire (DEQ-5) was performed. Preservation of the contralateral vidian nerve allowed comparison between the eye subjected to VN and the control eye postoperatively.
Twenty-one subjects were enrolled with no preoperative difference in
lacrimation between eyes (P = .617) and overall mild dry eye severity. Although the control eye had no difference in
lacrimation pre- and postoperatively, decreased tearing was noted in the VN eye at 1 month (20.8 mm vs. 15.8 mm, P = .015) and at 3 months (23.2 mm vs. 15.8 mm, P = .0051) postoperatively. Overall, no difference was noted in the DEQ-5 score for dry eye severity between the pre- and postoperative measures. However, six patients were noted to have moderate to severe dry eye severity postoperatively and five of these six had decreased
lacrimation (<20 mm) preoperatively. Patients with decreased tearing preoperatively demonstrated significantly worse postoperative DEQ-5 scores when compared to patients with normal tearing (P < .0056).
VN during EETA results in decreased tearing but is not associated with increased dry eye severity overall. However, patients with decreased tearing preoperatively are at risk for increased dry eye severity and should be counseled for this risk.
2 Laryngoscope, 131:1487-1491, 2021.