High position dacryocystorhinostomy for the treatment of chronic dacryocystitis following failed nasolacrimal duct stent implantation
10.3760/cma.j.cn115330-20250401-00192
- VernacularTitle:经鼻内镜高位泪囊鼻腔吻合术治疗鼻泪管支架植入失败的慢性泪囊炎
- Author:
Nan LIN
1
;
Muhan SHI
;
Min WANG
;
Mingwu LI
;
Tong GUO
;
Xiuquan LIU
;
Xinzhu WANG
;
Chen PENG
Author Information
1. 北京大学人民医院耳鼻咽喉头颈外科，北京 100044
- Publication Type:Journal Article
- Keywords:
Dacryocystitis;
Lacrimal duct stent;
Dacryocystorhinostomy;
Rosenmüller valve
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(9):1103-1110
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the surgical efficacy of high position dacryocystorhinostomy (DCR) under nasal endoscopy in patients with chronic dacryocystitis secondary to failure of nasolacrimal duct stent implantation.Methods:A total of 101 patients with chronic dacryocystitis who were treated at People′s Hospital of Peking University from 2013 to 2024 were retrospectively selected, including 14 males and 87 females, aged (56.82±13.00) years (Mean±SD). The patients were divided into control group (53 cases, 59 eyes) and stent group (48 cases, 60 eyes). The control group consisted of randomly selected patients with simple dacryocystitis, while, the stent group included patients with secondary dacryocystitis after failure of nasolacrimal duct stent implantation. All patients underwent endoscopic high DCR with exposed the Rosenmüller valve, combined with intraoperative lacrimal silicone tube implantation. After the operation, the surgical efficacy was evaluated by methods such as Munk score, endoscopic observation of intranasal ostia, lacrimal duct irrigation, and fluorescein test. SPSS 27.0 software was used for data statistics.Results:All 101 patients were followed up for at least one year after DCR surgery. In the control group, one patient (two eyes) was lost to follow-up; while, in the stent group, three patients (three eyes) were lost to follow-up, with one case diagnosed with lacrimal sac cancer. Excluding the lost-to-follow-up cases and the patient with lacrimal sac cancer, anatomical success was achieved in 54 eyes (96.4%, 54/56) in the stent group, and both anatomical and functional success in 53 eyes (94.6%, 53/56); in the control group, 55 eyes (96.5%, 55/57) achieved both anatomical and functional success. No statistically significant difference was found in postoperative effectiveness efficacy between the two groups ( χ2=0.000, P=0.984). Conclusion:For patients with secondary dacryocystitis after nasolacrimal duct stent implantation, high position DCR with exposure of Rosenmüller valve combined with lacrimal duct silicone intubation can achieve better long-term efficacy.
