{"title":"泪内窥镜引导下硅胶插管治疗原发性获得性鼻泪管阻塞的比较。","authors":"Seong Jung Ha, Min Kyu Yang, Ho-Seok Sa","doi":"10.1097/IOP.0000000000003027","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare surgical outcomes and complications between Crawford and Nunchaku-style tubes in dacryoendoscopy-guided silicone intubation for primary acquired nasolacrimal duct obstruction.</p><p><strong>Methods: </strong>We retrospectively reviewed 24 consecutive patients with bilateral primary acquired nasolacrimal duct obstruction who underwent dacryoendoscopy-guided silicone intubation with >6 months of follow-up. Crawford and Nunchaku-style tubes were used for OD and OS, respectively, and both were removed 6 months postoperatively. Surgical success was assessed at 9 months based on irrigation patency and epiphora relief. Complications, including tube extrusion and punctal slit, were monitored. We compared success rates and complications between groups and analyzed extrusion impact and punctal slit on surgical outcomes, and risk factors for punctal slit in the Nunchaku group.</p><p><strong>Results: </strong>Surgical success rates were 83.3% and 88.9% in the Crawford and Nunchaku groups, respectively (p = 1.000). Tube extrusion was more common in the Crawford group (29.2% vs. 0.0%, p = 0.009), whereas punctal slit was more frequent in the Nunchaku group (41.7% vs. 0.0%, p < 0.001). Neither tube extrusion nor punctal slit significantly affected surgical outcomes (p = 1.000 and p = 0.477, respectively). Diffuse obstruction observed on dacryoendoscopy was associated with a higher risk of punctal slit in the Nunchaku group, though not statistically significant (odds ratio = 6.000, p = 0.071).</p><p><strong>Conclusions: </strong>Crawford and Nunchaku-style tubes showed similar success rates. Nunchaku-style tubes reduce the need for nasal manipulation and extrusion risk but increase punctal slit risk. Clinicians should consider these differences when choosing tube type and optimizing surgical techniques.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Crawford and Nunchaku Tubes in Dacryoendoscopy-Guided Silicone Intubation for Primary Acquired Nasolacrimal Duct Obstruction.\",\"authors\":\"Seong Jung Ha, Min Kyu Yang, Ho-Seok Sa\",\"doi\":\"10.1097/IOP.0000000000003027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare surgical outcomes and complications between Crawford and Nunchaku-style tubes in dacryoendoscopy-guided silicone intubation for primary acquired nasolacrimal duct obstruction.</p><p><strong>Methods: </strong>We retrospectively reviewed 24 consecutive patients with bilateral primary acquired nasolacrimal duct obstruction who underwent dacryoendoscopy-guided silicone intubation with >6 months of follow-up. Crawford and Nunchaku-style tubes were used for OD and OS, respectively, and both were removed 6 months postoperatively. Surgical success was assessed at 9 months based on irrigation patency and epiphora relief. Complications, including tube extrusion and punctal slit, were monitored. We compared success rates and complications between groups and analyzed extrusion impact and punctal slit on surgical outcomes, and risk factors for punctal slit in the Nunchaku group.</p><p><strong>Results: </strong>Surgical success rates were 83.3% and 88.9% in the Crawford and Nunchaku groups, respectively (p = 1.000). Tube extrusion was more common in the Crawford group (29.2% vs. 0.0%, p = 0.009), whereas punctal slit was more frequent in the Nunchaku group (41.7% vs. 0.0%, p < 0.001). Neither tube extrusion nor punctal slit significantly affected surgical outcomes (p = 1.000 and p = 0.477, respectively). Diffuse obstruction observed on dacryoendoscopy was associated with a higher risk of punctal slit in the Nunchaku group, though not statistically significant (odds ratio = 6.000, p = 0.071).</p><p><strong>Conclusions: </strong>Crawford and Nunchaku-style tubes showed similar success rates. Nunchaku-style tubes reduce the need for nasal manipulation and extrusion risk but increase punctal slit risk. Clinicians should consider these differences when choosing tube type and optimizing surgical techniques.</p>\",\"PeriodicalId\":19588,\"journal\":{\"name\":\"Ophthalmic Plastic and Reconstructive Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmic Plastic and Reconstructive Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/IOP.0000000000003027\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic Plastic and Reconstructive Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IOP.0000000000003027","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Comparison of Crawford and Nunchaku Tubes in Dacryoendoscopy-Guided Silicone Intubation for Primary Acquired Nasolacrimal Duct Obstruction.
Purpose: To compare surgical outcomes and complications between Crawford and Nunchaku-style tubes in dacryoendoscopy-guided silicone intubation for primary acquired nasolacrimal duct obstruction.
Methods: We retrospectively reviewed 24 consecutive patients with bilateral primary acquired nasolacrimal duct obstruction who underwent dacryoendoscopy-guided silicone intubation with >6 months of follow-up. Crawford and Nunchaku-style tubes were used for OD and OS, respectively, and both were removed 6 months postoperatively. Surgical success was assessed at 9 months based on irrigation patency and epiphora relief. Complications, including tube extrusion and punctal slit, were monitored. We compared success rates and complications between groups and analyzed extrusion impact and punctal slit on surgical outcomes, and risk factors for punctal slit in the Nunchaku group.
Results: Surgical success rates were 83.3% and 88.9% in the Crawford and Nunchaku groups, respectively (p = 1.000). Tube extrusion was more common in the Crawford group (29.2% vs. 0.0%, p = 0.009), whereas punctal slit was more frequent in the Nunchaku group (41.7% vs. 0.0%, p < 0.001). Neither tube extrusion nor punctal slit significantly affected surgical outcomes (p = 1.000 and p = 0.477, respectively). Diffuse obstruction observed on dacryoendoscopy was associated with a higher risk of punctal slit in the Nunchaku group, though not statistically significant (odds ratio = 6.000, p = 0.071).
Conclusions: Crawford and Nunchaku-style tubes showed similar success rates. Nunchaku-style tubes reduce the need for nasal manipulation and extrusion risk but increase punctal slit risk. Clinicians should consider these differences when choosing tube type and optimizing surgical techniques.
期刊介绍:
Ophthalmic Plastic and Reconstructive Surgery features original articles and reviews on topics such as ptosis, eyelid reconstruction, orbital diagnosis and surgery, lacrimal problems, and eyelid malposition. Update reports on diagnostic techniques, surgical equipment and instrumentation, and medical therapies are included, as well as detailed analyses of recent research findings and their clinical applications.