The application of "" type nasal mucosa flaps during the surgical treatment of traumatic dacryocystitis

中国实用眼科杂志 Pub Date : 2017-05-10 DOI:10.3760/CMA.J.ISSN.1006-4443.2017.05.014

Ningshu Liu, Na Liu, Wenting He, C. Zhang

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Abstract

Objective To modify the nasal mucosa flap during dacryocystorhinostomy for the treatment of traumatic dacryocystitis and observe its therapeutic effect. Methods Twenty six patients (27 eyes) of traumatic dacryocystitis were performed dacryocystorhinostomy. During the operation, the anterior and posterior nasal mucosa flaps of "" type was sutured to that of lacrimal sac mucosa flaps of "H" type. During 6 months, the state of mucosa flaps, tear washing, and tearing symptom was followed up. Patients with median canthoal tendon interruption received tendon repairing simultaneously. Patients with obvious orbital fracture received orbital reconstruction 3 to 4 months later. Results Among 26 patients with traumatic dacryocystitis, 20 male, 6 female, aged 5 to 63. During the operation of all patients, the distance between the nasal mucosa and the lacrimal sac became widen. All had nasal bone, lacrimal bone fracture at different degree; 18 patients with median canthoal tendon interruption, and 14 patients with obvious orbital fracture. Tear washing was smooth in all cases at 2 weeks follow up. At 6 months follow up, tear washing was smooth in 26 cases (one child still had tearing symptom), obstruction in 1 case. Conclusions The nasal mucosa flap of "" type is 1 time longer and narrower than that of "H" type, and offer a new way for patients with traumatic dacryocystitis, whom the distance between the nasal mucosa and the lacrimal sac became widen. Key words: Dacryocysto rhinostomy; Chronic dacrycystitis; Trauma

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“”型鼻黏膜瓣在外伤性泪囊炎手术治疗中的应用

目的探讨外伤性泪囊炎鼻腔造口术中鼻黏膜瓣的改良及治疗效果。方法对外伤性泪囊炎患者26例(27眼)行泪囊鼻腔吻合术。术中将“”型鼻前、后黏膜瓣与“H”型泪囊黏膜瓣缝合。随访6个月，观察两组患者粘膜瓣形态、泪液冲洗情况及撕裂症状。中眦肌腱断裂患者同时行肌腱修复术。眼眶明显骨折的患者于3 ~ 4个月后行眼眶重建。结果外伤性泪囊炎26例，男20例，女6例，年龄5 ~ 63岁。所有患者在手术过程中，鼻黏膜与泪囊之间的距离变宽。鼻骨、泪骨均有不同程度骨折;18例有中眦肌腱断裂，14例有明显眶部骨折。随访2周后，所有病例的泪液冲洗均顺利。随访6个月时，26例患儿泪液冲洗顺畅(1例仍有泪液症状)，1例患儿泪液梗阻。结论“”型鼻黏膜瓣比“H”型长1倍，窄1倍，为鼻黏膜与泪囊距离变宽的外伤性泪囊炎患者提供了一条新途径。关键词:泪囊造鼻术;慢性dacrycystitis;创伤

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中国实用眼科杂志

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期刊介绍： China Practical Ophthalmology was founded in May 1983. It is supervised by the National Health Commission of the People's Republic of China, sponsored by the Chinese Medical Association and China Medical University, and publicly distributed at home and abroad. It is a national-level excellent core academic journal of comprehensive ophthalmology and a series of journals of the Chinese Medical Association. China Practical Ophthalmology aims to guide and improve the theoretical level and actual clinical diagnosis and treatment ability of frontline ophthalmologists in my country. It is characterized by close integration with clinical practice, and timely publishes academic articles and scientific research results with high practical value to clinicians, so that readers can understand and use them, improve the theoretical level and diagnosis and treatment ability of ophthalmologists, help and support their innovative development, and is deeply welcomed and loved by ophthalmologists and readers.