Observation on the Therapeutic Effect of High Dacryocystorhinostomy with Extended Bone Window and Continuous "Z" -Shaped Nasal Cavity-Dacryocystorhinostomy under Nasal Endoscopy in the Treatment of Chronic Dacryocystitis
Zhu Hanhao1, Lin Bin1, Tan Fucheng1, Lai Qiuyu2
1. Department of Otorhinolaryngology Head and Neck Surgery,Lianjiang People's Hospital 524400; 2. Department of Ophthalmology,Lianjiang People's Hospital 524400
Abstract：Objective To explore the clinical efficacy and safety of nasal endoscopic extended bone window with high dacryocystornostomy combined with continuous "Z" -shaped nasal cavity-dacryocystorous flap anastomosis(DCR)in the treatment of chronic dacryocystitis,and to conduct a comparative analysis with simple conservative drug treatment. Methods Retrospective clinical study.A total of 76 patients(83 eyes)diagnosed with chronic dacryocystitis were selected.The patients were divided into a conservative treatment group of 38 cases(40 eyes)and a surgical treatment group of 38 cases(43 eyes).Among them,the surgical group underwent high dacryocystornostomy with extended bone window under nasal endoscopy and continuous "Z"-shaped nasal cavity-dacryocystornomucosal flap anastomosis.The improvement rate of epiphora symptoms,lacrimal duct patency rate,complication rate and recurrence rate were compared between the two groups. Results Three months after the operation,the improvement rate of epiphora symptoms in the surgical group was 97.6%,and that in the conservative group was 50.0%(P<0.001).The lacrimal duct patency rate was 97.6% in the surgical group and 25.0% in the conservative group(P<0.001).The incidence of complications was 4.6% in the surgical group and 15.0% in the conservative group(P=0.082).The recurrence rate was 2.3% in the surgical group and 20.0% in the conservative group(P<0.001). Conclusion Compared with conservative treatment,the use of transnasal endoscopic extended bone window high dacryocystorhinostomy combined with continuous"Z" -shaped nasal cavity-dacryocystorhinostomy flap anastomosis for the treatment of chronic dacryocystitis can significantly improve the therapeutic effect,improve the patency of the lacrimal duct,reduce the risk of recurrence,and have fewer complications.It is an effective method for the treatment of chronic dacryocystitis.
朱汉豪, 林斌, 谭富诚, 赖秋余. 鼻内镜下扩展骨窗高位泪囊鼻腔造口并连续“Z”形鼻腔-泪囊黏膜瓣吻合术治疗慢性泪囊炎的疗效观察[J]. 哈尔滨医药, 2025, 45(6): 42-46.
Zhu Hanhao, Lin Bin, Tan Fucheng, Lai Qiuyu. Observation on the Therapeutic Effect of High Dacryocystorhinostomy with Extended Bone Window and Continuous "Z" -Shaped Nasal Cavity-Dacryocystorhinostomy under Nasal Endoscopy in the Treatment of Chronic Dacryocystitis. journal1, 2025, 45(6): 42-46.
[1] Islam MR,Wadud SA,Akhanda AH,et al.Outcome of transcanalicular endolaser and external dacryocystor-hinostomy in chronic dacryocystitis.Mymensingh Med J 2018;27:673-8. [2] Tang LF,Qin G,Yang YC,et al.Therapeutic effect of two kinds of surgical treatment for chronic dacryocystitis:external dacryocystorhinostomy and endoscopic dacryo-cystorhinostomy.Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017;31:1029-31. [3] 周兵,唐忻.鼻内窥镜下鼻内泪囊鼻腔造孔术(附35例疗效分析).耳鼻咽喉-头颈外科,1994,1(2):80-83. [4] 王旻,王思祁,张杰,等.泪囊鼻腔吻合术中暴露Rosen-müller瓣治疗难治性鼻泪管阻塞.中华耳鼻咽喉头颈外科杂志,2016,51(7):522-527. [5] 周兵,韩德民,黄谦,等.鼻内镜泪囊鼻腔造孔术远期疗效随访.中华耳鼻咽喉头颈外科杂志,2008,43(1):13-17. [6] 刘大英,王宗杰,裴喜玲,等.鼻内镜下经鼻高位泪囊鼻腔吻合术治疗慢性泪囊炎的临床观察[J].中国耳鼻咽喉头颈外科,2021,28(09):577-578. [7] 沈丽冬,沈惠,金烨,等.208例慢性泪囊炎患者病原菌检出情况及药敏试验结果分析[J].浙江医学,2025,47(01):64-67+71. [8] 张睿,郑景华.改良泪道冲洗术在慢性泪囊炎治疗中的应用[J].中国基层医药,2016,23(05):743-747. [9] 陆卫锋,廖卫明,危虎贲.妥布霉素、地塞米松联合泪道探通术治疗泪道阻塞的效果观察[J].华夏医学,2023,36(03):140-143. [10] 孙华,许思思,李勇,等.碘海醇注射液在CT泪道造影中的应用研究[J].中国耳鼻咽喉头颈外科,2020,27(02):76-78. [11] 郑十五,王十六.糠酸莫米松鼻喷雾剂在鼻科手术中的应用进展[J].中国耳鼻咽喉头颈外科,2024,31(3):156-160. [12] 黄诗恩,徐景利,张钦,等.鼻内镜下高位泪囊鼻腔吻合术28例报告[J].中国微创外科杂志,2021,21(04):356-361. [13] [白亚亚,贺经,杜青卫.慢性泪囊炎的病理学研究进展[J].国际眼科杂志,2020,20(12):2092-2095. [14] 杨平孙,陈卫兵.经鼻内窥镜下扩展性骨窗伴高位造口行泪囊鼻腔吻合术治疗慢性泪囊炎[J].国际眼科杂志,2023,23(05):860-863. [15] 王雯雯. 泪囊鼻腔吻合口不同处理方式对慢性泪囊炎EES-DCR疗效的影响[D].吉林大学,2020.
2025, Vol. 45 
