nasolacrimal duct

鼻泪管
  • 文章类型: Journal Article
    虽然眼睛可以接受治疗操作,它的一些结构非常难以接近。因此,常规治疗给药途径,如局部或全身途径,通常表现出明显的局限性,表现为低眼部穿透性或出现与生理学有关的副作用,在其他人中。许多外源性物质的关键特征是从浓缩的泪液储库到相对贫瘠的角膜和结膜上皮的药物梯度,这迫使被动的吸收途径。在相反的方向上也是如此,眼表(OS)。在眼泪可以被视为等同于或替代血浆的前提下,研究人员可以确定OS液中的药物浓度.在这个框架内,对该主题的学术来源进行了调查。它提供了当前知识的概述,允许识别相关理论,方法,以及现有研究中可用于后续研究的空白。OS流体(特别是泪液)作为用于外部药物筛选的生物材料来源和作为各种全身性疾病的生物标志物具有巨大潜力。鉴于众多替代矩阵,了解它们的特性对于在毒理学分析中选择最合适的标本非常重要。
    Although the eye can be subjected to therapeutic manipulation, some of its structures are highly inaccessible. Thus, conventional therapeutic administration pathways, such as topical or systemic routes, usually show significant limitations in the form of low ocular penetration or the appearance of side effects linked to physiology, among others. The critical feature of many xenobiotics is the drug gradient from the concentrated tear reservoir to the relatively barren corneal and conjunctival epithelia, which forces a passive route of absorption. The same is true in the opposite direction, towards the ocular surface (OS). With the premise that tears can be regarded as equivalent to or a substitute for plasma, researchers may determine drug concentrations in the OS fluid. Within this framework, a survey of scholarly sources on the topic was conducted. It provided an overview of current knowledge, allowing the identification of relevant theories, methods, and gaps in the existing research that can be employed in subsequent research. OS fluid (tears particularly) has enormous potential as a source of biological material for external drug screening and as a biomarker of various systemic diseases. Given the numerous alternate matrices, knowledge of their properties is very important in selecting the most appropriate specimens in toxicological analyses.
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  • 文章类型: Journal Article
    背景:这项前瞻性临床研究评估了硅胶支架管(SST)对鼻内镜下泪囊鼻腔吻合术(EN-DCR)治疗原发性获得性鼻泪管阻塞成功率的影响。
    方法:患者在3个月的时间内随机分配接受有或没有SST插管的EN-DCR。使用标准化技术进行手术。在三个不同的时间点对患者进行评估:一天,术后12周和24周。比较结果以评估统计学差异。手术的成功取决于积极的冲洗程序,以及通过改善症状和高水平的患者满意度。
    结果:共有56例随机病例完成了24周的随访。1例患者因鼻泪管阻塞的恶性发生而退出。在24周的随访之后,没有发现在溢唇水平(p>.10)或通畅性(p>.16)方面的统计学显著差异。关于时间变化的比较没有显示出显著性水平(p>.28)。
    结论:本研究无法证实在EN-DCR中插入SST有统计学上显著的益处或缺点。
    BACKGROUND: This prospective clinical study evaluates the effect of a silicone stent tube (SST) on the success rate of endonasal-endoscopic dacryocystorhinostomy (EN-DCR) to treat primary acquired nasolacrimal duct obstruction.
    METHODS: Patients were randomly assigned to receive EN-DCR with or without SST intubation over a period of 3 months. The surgery was performed using standardized techniques. Patients were assessed at three different timepoints: one day, 12 weeks and 24 weeks after the surgery. The results were compared in order to evaluate statistical differences. Surgical success was determined by means of positive irrigation procedures, as well as by the improvement of symptoms and a high level of patient satisfaction.
    RESULTS: A total of 56 randomized cases completed 24 weeks of follow up. 1 Patient dropped out due to malignant genesis of the nasolacrimal duct obstruction. After 24 weeks of follow up no statistically significant differences in levels of epiphora (p > .10) or patency (p > .16) were revealed. Comparisons regarding changes in time did not show levels of significance (p > .28).
    CONCLUSIONS: This study could not confirm a statistically significant benefit or disadvantage for SST Insertion in EN-DCR.
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  • 文章类型: Journal Article
    目的:探讨原发性获得性鼻泪管阻塞(PANDO)患者干眼(DE)的患病率和泪膜稳定性的变化。
    方法:在此横截面中,观察性研究,对223例PANDO患者的370只眼进行了评估。眼表疾病指数(OSDI)用于评估眼表症状,并使用角膜摄影5M无创眼表分析仪评估眼表参数。根据TFOSDEWSII标准,OSDI≥13且NIKBUT<10s的患者被诊断为DE。
    结果:在223名PANDO患者中,65(29.1%)符合DE的诊断标准。与没有DE的患者相比,患有DE的PANDO患者明显年龄较大(p<0.001),有一个较长的持续时间的溢泪(p=0.023),并且更可能对泪囊压力(ROPLAS)信号(p=0.003)有正反流。多因素分析表明,年龄较大,ROPLAS阳性和高血压是DE的显著独立预测因子(p<0.05)。在147例无DE的单侧PANDO患者中,TMH,NIKBUT-First,PANDO两侧的NIKBUT平均和球红斑评分明显较高。
    结论:这项研究表明,在PANDO患者中,DE的患病率为29.1%,并且在年龄较大的患者中更容易发生,有高血压,ROPLAS阳性。此外,单侧鼻泪管阻塞的患者,在健康眼睛中观察到泪膜稳定性降低。
    OBJECTIVE: Exploring the prevalence of dry eye (DE) and the changes of tear film stability in patients with primary acquired obstruction of the nasolacrimal duct (PANDO).
    METHODS: In this cross-sectional, observational study, 370 eyes in 223 patients with PANDO were assessed. The ocular surface disease index (OSDI) was used to evaluate ocular surface symptoms, and the Keratograph 5M non-invasive ocular surface analyser was used to assess ocular surface parameters. According to the TFOS DEWS II criteria, patients with OSDI ≥ 13 and NIKBUT < 10 s were diagnosed with DE.
    RESULTS: Of the 223 PANDO patients, 65 (29.1%) met the diagnostic criteria for DE. Compared with patients without DE, PANDO patients with DE were significantly older (p < 0.001), had a longer duration of epiphora (p = 0.023), and more likely to have a positive regurgitation on pressure over the lacrimal sac (ROPLAS) sign (p = 0.003). Multifactorial analysis showed that older age, positive ROPLAS and hypertension were significant independent predictors of DE (p < 0.05). Among the 147 unilateral PANDO patients without DE, the TMH, NIKBUT-first, NIKBUT-average and bulbar erythema scores were significantly higher in the PANDO sides.
    CONCLUSIONS: This study illustrated the prevalence of DE in PANDO patients was 29.1% and DE is more likely to occur in those who are older, have hypertension and are positive for ROPLAS. In addition, in patients with unilateral nasolacrimal duct obstruction, a decrease in tear film stability was observed in the healthy eye.
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  • 文章类型: Journal Article
    目的:I-131治疗后与分化型甲状腺癌(DTC)相关的最常见的泪器功能障碍是干眼和鼻泪管阻塞(NLDO),导致患者眼部不适和生活质量下降。诊断和管理与I-131治疗DTC相关的泪器功能障碍至关重要。因此,本文旨在全面总结和分析I-131治疗DTC导致泪器功能障碍的机制和治疗方案的进展。
    方法:CNKI综合检索,PubMed,和WedofScience从数据库中进行到2023年12月。关键搜索词是\"甲状腺癌\",\"I-131\",“并发症”,\"干眼\",\"Epiphora\",\"眼泪\",“鼻泪管”和“NLDO”。
    结果:研究表明,I-131治疗DTC会对泪腺和鼻泪管系统造成损害,导致干眼症等症状,顿唇,还有粘液分泌物.此外,最近的研究集中在探索疾病的相关危险因素以及实验和临床治疗。然而,关于所涉及的机制存在一些争议,无论是由于I-131在眼泪中的被动流动,泪囊和鼻泪管中的钠碘转运体(NIS)主动摄取I-131,或由I-131引起的继发性代谢和激素紊乱。
    结论:眼科医生的早期发现和预防措施至关重要,并且需要进一步研究以阐明该疾病的潜在机制。
    OBJECTIVE: The most prevalent lacrimal apparatus dysfunctions associated with differentiated thyroid cancer(DTC) after I-131 therapy are dry eye and nasolacrimal duct obstruction(NLDO), leading to ocular discomfort and lower quality of life for patients. It is crucial to diagnose and manage lacrimal apparatus dysfunction associated with I-131 therapy for DTC. Therefore, this review aims to comprehensively summarize and analyze the advances in mechanisms and therapeutic options underlying lacrimal apparatus dysfunction induced by I-131 therapy for DTC.
    METHODS: A comprehensive search of CNKI, PubMed, and Wed of Science was performed from the database to December of 2023. Key search terms were \"Thyroid cancer\", \"I-131\", \"Complications\", \"Dry eye\", \"Epiphora\", \"Tear\", \"Nasolacrimal duct\" and \"NLDO\".
    RESULTS: The research indicates that I-131 therapy for DTC causes damage to the lacrimal glands and nasolacrimal duct system, resulting in symptoms such as dry eye, epiphora, and mucoid secretions. Moreover, recent research has focused on exploring relevant risk factors of the condition and experimental and clinical treatments. However, there is some controversy regarding the mechanisms involved, whether it is due to the passive flow of I-131 in tears, active uptake of I-131 by the sodium-iodide symporter (NIS) in the lacrimal sac and nasolacrimal duct, or secondary metabolic and hormonal disturbances caused by I-131.
    CONCLUSIONS: It is crucial for early detection and preventive measures by ophthalmologists and the need for further studies to elucidate the mechanisms underlying the disease.
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  • 文章类型: Case Reports
    持续接触外来物质会引发体内持续的炎症反应,随后的慢性炎症被认为是淋巴瘤的原因之一。由异物引起的大多数淋巴瘤由两种主要表型组成。金属假体引起的弥漫性大B细胞淋巴瘤,也称为金属植入物相关淋巴瘤和T细胞表型间变性大细胞淋巴瘤,通常与乳房植入物有关。通常进行隆鼻成形术以改善鼻背的美观性,并且各种合成材料已被用作植入物。几乎没有记录到源自鼻植入物的淋巴瘤的发生,更罕见的是其表现为EB病毒(EBV)阴性结外边缘区淋巴瘤。这里,作者描述了一例罕见的鼻和鼻泪管B细胞淋巴瘤病例,该病例发生在一名49岁女性中,该女性在20年前用硅胶植入物进行了隆鼻手术.
    Continuous exposure to foreign substances initiates a sustained inflammatory reaction in the body, and subsequent chronic inflammation is recognized as one of the causes of lymphoma. Most lymphomas caused by foreign bodies are composed of 2 major phenotypes. Diffuse large B-cell lymphoma arising from metallic prosthesis, also called metallic implant-associated lymphoma and T-cell phenotype anaplastic large cell lymphoma, commonly associated with breast implants. Augmentation rhinoplasty is often performed to improve the esthetics of the nasal dorsum and various synthetic materials have been used as implants. The occurrence of lymphoma originating from a nasal implant is scarcely documented, and even more uncommon is its manifestation as epstein-barr virus (EBV)-negative extranodal marginal zone lymphoma. Here, the authors describe a rare case of B-cell lymphoma of the nose and nasolacrimal duct in a 49-year-old woman who underwent rhinoplasty with a silicone implant 20 years ago.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    目的:通过使用新的和重复使用的球囊导管,研究球囊泪滴成形术(BD)或(BDCP)治疗持续性先天性鼻泪管阻塞(pCNLDO)儿童的结果。
    方法:我们的回顾性分析侧重于使用BD或BDCP技术管理pCNLDO。该研究包括年龄>1岁至<12岁的儿童,这些儿童之前接受过单次或多次探查。我们具体的泪道检查包括详细的病史和检查,如之前发布的。我们用传统的,直,2mm×13mm/3mm×15mm泪球(FCI,Ophthacath)。我们已经描述了将相同的导管用于三个BD程序的技术(1个新的+2个重复使用)。结果被归类为完全成功,部分成功,和失败。每个孩子的最低随访时间为6个月。
    结果:我们分析了64名儿童(89只眼),平均年龄为58个月(15-132个月)。所有儿童(100%)均有溢唇,并有出院和FDDT阳性。所有儿童在全身麻醉下接受了BD-59只眼睛的新气球和30只眼睛的重复使用气球。气球经过等离子灭菌,类似于玻璃体切割术切割器和超声乳化机的管道。我们注意到重复使用的气球有三个泄漏(2个来自气球尖端,1个来自塑料轮毂)。平均随访14.5个月,77只眼睛(86.5%)(52只新眼睛,25只重复使用)取得了圆满成功,而8只眼部分成功(8.9%)(4只新眼和4只眼重复使用)。四只眼睛(4.5%)发现BD失败(3次新出现,1次重复使用)。新的或重复使用的气球没有明显的并发症。
    结论:BD或BDCP是一种快速,安全,easy,以及令人满意地解决pCNLDO症状的有效程序。在pCNLDO中,可以小心地重复使用常规球囊导管,并具有可比的功效,并且没有其他并发症。
    OBJECTIVE: To study the outcomes of balloon dacryoplasty (BD) or (BDCP) in children with persistent congenital nasolacrimal duct obstruction (pCNLDO) by using new and reused balloon catheters.
    METHODS: Our retrospective analysis focused on managing pCNLDO by using the BD or BDCP technique. The study included children aged >1 year to <12 years who underwent single or multiple probings before. Our specific lacrimal workup included a detailed history and examination, as published earlier. We used conventional, straight, 2 mm × 13 mm/3 mm × 15 mm lacrimal balloons (FCI, Ophthacath). We have described a technique to use the same catheter for three BD procedures (1 new + 2 reuse). The outcomes were categorized as complete success, partial success, and failure. The minimum follow-up of each child was 6 months.
    RESULTS: We analyzed 64 children (89 eyes) with a mean age of 58 months (15-132 months). All children (100%) had epiphora with discharge and positive FDDT. All children underwent BD under general anesthesia - new balloons in 59 eyes and reused balloons in 30 eyes. The balloons were plasma sterilized akin to vitrectomy cutters and tubings of phaco machines. We noted three leaks from reused balloons (2 from the balloon tip and 1 from the plastic hub). At a mean follow-up of 14.5 months, complete success was noted in 77 eyes (86.5%) (52 new and 25 reuse), while 8 eyes had partial success (8.9%) (4 new and 4 reuse). Failure of BD was noted in four eyes (4.5%) (3 new and 1 reuse). None had significant complications with new or reused balloons.
    CONCLUSIONS: BD or BDCP is a quick, safe, easy, and effective procedure that resolves pCNLDO symptoms satisfactorily. Carefully reusing a conventional balloon catheter is possible with comparable efficacy and no additional complications in pCNLDO.
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  • 文章类型: Journal Article
    背景:利用扩大的内镜方法对上颌窦进行各种肿瘤的鼻内治疗越来越受欢迎。鼻泪管(NLD)可能会意外受伤,或者在肿瘤切除期间需要切除或增强可视化。全国民主联盟的管理可以单独采取横切的形式,带支架的横断,或进行正式的泪囊鼻腔吻合术,以避免术后受伤的后遗症。这项研究的目的是回顾文献并确定在扩大上颌窦入路期间NLD的最佳管理。
    方法:对Ovid,Embase,Medline,和Cochrane数据库用于确定涉及扩展上颌窦入路的研究,并明确报告了NLD的状态和术后结局.
    结果:19项研究纳入分析,分为两组:NLD保留(n=9项研究;n=191例患者)和NLD参与(n=10项研究;n=296例患者)。在保留NLD的子群中,在191例患者的一个亚组中,有1例患者(0.5%)出现了溢泪.在涉及全国民主联盟的小组中,单独的锐利横切是最常见的NLD去除方法,并且与低的溢泪率相关(研究率:0至18.2%;聚集的亚组率:7.0%,21/296)。症状的自发消退是常见的(60%-100%病例)。
    结论:从暴露和肿瘤控制的角度来看,如果可行,应保留NLD。当病理或方法需要移除NLD时,持续性的出泪率很低,不管手术技术。当采用扩大上颌入路时,特别是对于良性肿瘤,并且需要移除NLD,锋利横切是最简单的去除方法,提供了一个低比率的术后溢泪,并得到现有文献的支持。
    BACKGROUND: Utilizing expanded endoscopic approaches to the maxillary sinus for the endonasal management of a variety of tumors is increasing in popularity. The nasolacrimal duct (NLD) may be injured inadvertantly or need to be removed during tumor resection or to augment visualization. Management of the NLD can take the form of transection alone, transection with stenting, or performing a formal dacryocystorhinostomy to avoid postoperative sequelae of injury. The purpose of this study was to review the literature and determine the optimal management of the NLD during expanded maxillary sinus approaches.
    METHODS: A systematic review of Ovid, Embase, Medline, and Cochrane databases was performed to identify studies involving expanded approaches to the maxillary sinus and that explicitly reported the status of the NLD and postoperative outcomes.
    RESULTS: Nineteen studies were included in the analysis and divided into two groups: NLD-preserving (n = 9 studies; n = 191 patients in aggregate) and NLD-involving (n = 10 studies; n = 296 patients in aggregate). In the NLD-preserving subgroup, one patient out of a subgroup aggregate of 191 patients (0.5%) developed epiphora. In the NLD-involving subgroup, sharp transection alone was the most common method of NLD removal and was associated with a low rate of epiphora (study rates: 0 to 18.2%; aggregated subgroup rate: 7.0%, 21 / 296). Spontaneous resolution of symptoms was common (60%-100% cases).
    CONCLUSIONS: The NLD should be preserved when feasible from an exposure and tumor-control perspective. When pathology or approach requires the removal of the NLD, rates of persistent epiphora are very low, regardless of surgical technique. When expanded maxillary approaches are employed, particularly for benign tumors, and require removal of the NLD, sharp transection is the simplest method of removal, provides a low rate of postoperative epiphora, and is supported by the available literature.
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  • 文章类型: Case Reports
    目的:描述使用内窥镜辅助犬进行微创泪囊鼻腔造口术,以成功治疗鼻泪管囊肿(泪囊)。
    方法:一名4岁的女性对美国StaffordshireTerrier进行了慢性溢唇和右眼鼻冠腹侧肿胀,并反向打喷嚏。
    方法:计算机断层扫描显示右鼻泪管充满液体的囊性病变,并伴有广泛的鼻延伸和继发性阻塞性额窦炎。在没有微生物生长的情况下,穿刺穿刺液和组织病理学证实了该结构的囊性。2.7毫米,30度,将带有关节镜套管的11厘米前斜内窥镜通过背侧颊隐窝的粘膜刺伤切口进入囊肿,以进行探查。通过皮肤将单独的器械入口放置在囊肿的中心,从而可以使用半月板探针进行经皮泪囊鼻腔造口术。在内窥镜检查中,尾鼻窦没有明显的清晰交流。进行了小的额窦钻孔,灌洗很容易流入囊腔并流出鼻孔。
    结果:术后10天和17个月的随访显示临床体征完全缓解,美容效果良好。
    结论:内镜辅助泪囊鼻腔造口术是一种有效的微创技术,可以治疗犬右侧鼻泪管的功能性阻塞性泪囊。
    OBJECTIVE: To describe the use of an endoscope to assist in performing minimally invasive dacryocystorhinostomy in a dog to successfully manage a nasolacrimal duct cyst (dacryocyst).
    METHODS: A 4-year-old female spayed American Staffordshire Terrier with chronic epiphora and swelling ventromedial to the nasal canthus of the right eye and reverse sneezing.
    METHODS: Computed tomography revealed a fluid-filled cystic lesion of the right nasolacrimal duct with extensive nasal extension and secondary obstructive frontal sinusitis. Aspiration of serosanguinous fluid with no growth of microbial organisms and histopathology confirmed the cystic nature of the structure. A 2.7 mm, 30 deg, 11 cm foreward-oblique endoscope with arthroscopic cannula was passed through a mucosal stab incision in the dorsal buccal recess into the cyst to allow for exploration. A separate instrument portal was placed in the center of the cyst through the skin which allowed for transcutaneous dacryocystorhinostomy with a meniscal probe to be performed. No clear communication was evident caudodorsally into the frontal sinus on endoscope examination. A small frontal sinus trephination was performed and lavage flowed easily into the cystic cavity and out of the nostril.
    RESULTS: Follow-up at 10 days and 17 months postoperatively showed complete resolution of clinical signs with an excellent cosmetic outcome.
    CONCLUSIONS: Endoscopy-assisted dacryocystorhinostomy demonstrated an effective minimally invasive technique to treat a functionally obstructive dacryocyst of the right nasolacrimal duct in a dog.
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  • 文章类型: Journal Article
    The article analyzes the literature data concerning the anatomical structure of the tear ducts with a focus on morphometric studies of individual structures. It is noted that, despite the high information content of cadaveric studies, most of the information to date has been obtained with the use of intravital radiation visualization methods. It is shown that the lacrimal drainage system has age, gender, and racial characteristics. Most studies focus on features of the bone nasolacrimal canal, while there is a relative shortage of research devoted to soft-tissue nasolacrimal duct. The analysis showed that most of the studies are devoted to particular morphometric indicators, which makes it difficult to obtain a complete objective picture of the size of the tear duct. Information about its volume can be found only in a couple of studies. The numerical values of the obtained data vary, which can be explained by a different approach to the selection of research subjects, sample sizes, anatomical criteria and the calculation method of morphometric parameters. There are only a few studies on morphometric parameters of the nasolacrimal duct in healthy humans, which is extremely important for determining the pathogenesis of disorders of the patency of the lacrimal drainage system.
    Проанализированы данные литературы, касающиеся анатомического строения слезоотводящих путей с фокусировкой на морфометрические исследования отдельных структур. Отмечено, что, несмотря на высокую информативность кадаверных исследований, большинство сведений к настоящему времени получено в результате прижизненного применения лучевых визуализирующих методов. Показано, что слезоотводящие пути имеют возрастные, гендерные и расовые особенности. Большинство исследований сосредоточено на изучении особенностей костного носослезного канала, в то время как имеется относительный дефицит работ, посвященных изучению мягкотканного носослезного протока. Анализ показал, что в публикациях приведены преимущественно отдельные морфометрические показатели, и это затрудняет получение целостной объективной картины размеров носослезного канала. Сведения о его объеме представлены в единичных работах. Цифровые значения полученных данных разнятся, что можно объяснить различными подходами к отбору субъектов исследования, размеров выборки, анатомических критериев и методов вычисления морфометрических показателей. Практически отсутствуют работы по изучению морфометрических показателей носослезного протока в норме, информация о которых крайне важна для определения патогенеза нарушений проходимости слезоотводящих путей.
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