■鼻泪管阻塞通常使用内窥镜或外部泪囊鼻腔造口术(DCR)进行治疗。内窥镜和外部入路的解剖结果被认为是极好的。然而,解剖成功并不能转化为患者的满意度。本研究使用基于症状的泪腺症状问卷(Lac-Q)评估术前和术后泪腺问题,并根据手术技术的选择调查患者的满意度。
■总共112名符合条件的患者在眼科和耳部使用外部或鼻内DCR治疗泪道问题,鼻子,和Skane大学医院的喉部诊所,斯堪尼亚,瑞典,在四年的时间里,参加了这项回顾性研究。如果患者在术前经历了泪滴和泪管狭窄,则认为他们符合条件。他们使用外部或鼻内DCR进行治疗,并被允许自由选择技术。排除标准包括先前的同侧DCR,先天性NLDO,年龄<18岁,癌症的存在,以前的眼眶创伤,或不遵守术后随访。手术后,患者接受了Lac-Q检查,以评估术前和术后的泪腺症状。增加了与手术疤痕和患者对手术的总体满意度有关的补充问题。
■总共,67(60%)年龄在18至88岁之间的患者完成了问卷,其中33例(49%)接受了外部DCR和34例(51%)鼻内DCR。在67名受访者中,51(76%)是女性,16(24%)是男性。患者在Lac-Q上对术前泪道问题评分很高,报告由于顿唇引起的症状和社会问题。手术后,接受外部DCR的组下班回家2-14天(中位数,3.5天)。然而,17人(52%)退休。经鼻DCR后,患者在家停留0-7天(中位数,2天)。大多数患者在DCR手术后满意,这两种技术都显著提高了总量,泪腺症状,和社会影响得分(均P<0.001)。外部DCR组与鼻内DCR组术后满意度差异无统计学意义(P>0.05)。少数患者在外部DCR后表达了与疤痕相关的担忧。
■患者认为泪道问题是显著的症状和社会负担。无论采用何种手术方式,术后满意度和症状缓解均良好。进一步的前瞻性研究评估患者满意度及其与体外和鼻内DCR后解剖和功能成功率的相关性,实用,现实世界的影响。
UNASSIGNED: Nasolacrimal duct obstruction is usually treated using endoscopic or external dacryocystorhinostomy (DCR). The anatomic outcomes of both the endoscopic and external approaches are considered excellent. However, anatomic success does not translate into patient satisfaction. The current study assessed pre- and postoperative lacrimal problems using the symptom-based Lacrimal Symptom Questionnaire (Lac-Q) and investigated patient satisfaction depending on the choice of surgical technique.
UNASSIGNED: A total of 112 eligible patients with lacrimal problems treated using external or endonasal DCR at the ophthalmology and ear, nose, and throat clinics at Skane University Hospital, Scania, Sweden, over a four-year period, were enrolled in this retrospective study. Patients were considered eligible if they experienced preoperative epiphora and had lacrimal duct stenosis. They were offered treatment using either external or endonasal DCR and were allowed to freely choose the technique. Exclusion criteria consisted of previous ipsilateral DCR, congenital NLDO, age < 18 years, presence of cancer, previous orbital trauma, or noncompliance with postoperative follow-up. After surgery, the patients were sent the Lac-Q to evaluate their lacrimal symptoms pre- and postoperatively. Complementary questions were added pertaining to the operative scar and the patients\' overall satisfaction with the operation.
UNASSIGNED: In total, 67 (60%) patients with ages ranging from 18 to 88 years completed the questionnaire, 33 (49%) of whom underwent external DCR and 34 (51%) endonasal DCR. Of the 67 respondents, 51 (76%) were women and 16 (24%) were men. Patients scored preoperative lacrimal problems highly on the Lac-Q, reporting both symptomatic and social problems due to epiphora. Following surgery, the group that underwent external DCR remained home from work for 2 - 14 days (median, 3.5 days). However, 17 (52%) were retired. After the endonasal DCR, the patients remained home for 0 - 7 days (median, 2 days). Most patients were satisfied after DCR surgery, with both techniques significantly improving total, lacrimal symptom, and social impact scores (all P < 0.001). No differences in postoperative satisfaction were observed between the external DCR and endonasal DCR groups (P > 0.05). A small number of patients expressed scar-related concerns after external DCR.
UNASSIGNED: The patients perceived lacrimal problems as a significant symptomatic and social burden. Postoperative satisfaction and symptom relief were good regardless of the surgical approach. Further prospective studies assessing patient satisfaction and its correlation with anatomical and functional success rates after external and endonasal DCR could provide robust, practical, real-world implications.