Objective:To investigate the efficacy and safety of lacrimal sac massage, lacrimal duct lavage, and dacryocystorhinostomy in combination for the treatment of congenital dacryocystitis.Methods:This study used a prospective study design, enrolling 150 children diagnosed with congenital dacryocystitis who received treatment at the Department of Ophthalmology, Shaoxing Maternity and Child Healthcare Hospital between January 2021 and December 2023. The children were randomly assigned to either a control group or an observation group using a random number table method. The control group ( n = 75) received lacrimal sac massage and lacrimal duct lavage, while the observation group ( n = 75) underwent a combination of lacrimal sac massage, lacrimal duct lavage, and dacryocystorhinostomy. Tear secretion score, level of inflammatory factor C-reactive protein, clinical efficacy, and complications (false passages, eyelid edema, and damage to the lacrimal duct mucosa) were compared between the two groups. Results:At 3 months after treatment, tear secretion score in the observation group was significantly lower than that in the control group [(1.55 ± 0.39) vs. (2.62 ± 0.58), t = 13.26, P < 0.05). At 3 months after treatment, the C-reactive protein level in the observation group was significantly lower than that in the control group [(1.38 ± 1.10) mg/L vs. (3.14 ± 1.27) mg/L, t = 9.07, P < 0.05). The cure rate in the observation group was significantly higher than that in the control group [97.33% (73/75) vs. 88.00% (66/75), χ2 = 4.81, P < 0.05]. There was no significant difference in the incidence of complications between the observation and control groups [9.33% (7/75) vs. 6.67% (5/75), χ2 = 0.36, P > 0.05]. Conclusions:The combination of lacrimal sac massage, lacrimal duct irrigation, and lacrimal duct probing has shown good efficacy in treating congenital dacryocystitis. This approach can decrease the severity of tearing, reduce the levels of inflammatory factors, achieve a high overall response rate, and lead to fewer complications.

Objective:To investigate the efficacy and safety of lacrimal sac massage, lacrimal duct lavage, and dacryocystorhinostomy in combination for the treatment of congenital dacryocystitis.Methods:This study used a prospective study design, enrolling 150 children diagnosed with congenital dacryocystitis who received treatment at the Department of Ophthalmology, Shaoxing Maternity and Child Healthcare Hospital between January 2021 and December 2023. The children were randomly assigned to either a control group or an observation group using a random number table method. The control group ( n = 75) received lacrimal sac massage and lacrimal duct lavage, while the observation group ( n = 75) underwent a combination of lacrimal sac massage, lacrimal duct lavage, and dacryocystorhinostomy. Tear secretion score, level of inflammatory factor C-reactive protein, clinical efficacy, and complications (false passages, eyelid edema, and damage to the lacrimal duct mucosa) were compared between the two groups. Results:At 3 months after treatment, tear secretion score in the observation group was significantly lower than that in the control group [(1.55 ± 0.39) vs. (2.62 ± 0.58), t = 13.26, P < 0.05). At 3 months after treatment, the C-reactive protein level in the observation group was significantly lower than that in the control group [(1.38 ± 1.10) mg/L vs. (3.14 ± 1.27) mg/L, t = 9.07, P < 0.05). The cure rate in the observation group was significantly higher than that in the control group [97.33% (73/75) vs. 88.00% (66/75), χ2 = 4.81, P < 0.05]. There was no significant difference in the incidence of complications between the observation and control groups [9.33% (7/75) vs. 6.67% (5/75), χ2 = 0.36, P > 0.05]. Conclusions:The combination of lacrimal sac massage, lacrimal duct irrigation, and lacrimal duct probing has shown good efficacy in treating congenital dacryocystitis. This approach can decrease the severity of tearing, reduce the levels of inflammatory factors, achieve a high overall response rate, and lead to fewer complications.

Objective:To observe the effect of applying repetitive transcranial magnetic stimulation (rTMS) on swallowing function and auditory evoked potentials in the brain-stems of stroke survivors with dysphagia.Methods:Sixty stroke survivors with dysphagia were randomly assigned to an observation group and a control group, each of 30. Both groups were given 30 minutes of routine swallowing training 6 times a week for 5 weeks, while the observation group was additionally provided with two-second bursts of rTMS on the left and right brain hemispheres alternately for 20 minutes daily. The frequency was 3.0Hz and the strength was 80% of the resting motor threshold (RMT), with an interval of 10 seconds between bursts. Before and after the treatment, both groups′ swallowing was assessed using the functional communication measure (FCM) and the modified Mann swallowing capacity evaluation scale (MMASA). Brainstem auditory evoked potentials (BAEP) were recorded to detect any changes in the peak latency (PL) and inter-peak latency (IPL). The clinical efficacy was also observed.Results:After the treatment, the average FCM results of both groups had improved significantly, but the observation group had improved significantly more. The average MMASA total scores and the average scores on all the sub-items had improved significantly more in the observation group except for the expressive speech disorder and anarthria scores. After the treatment, improvement was observed in respiration, anarthria, range of motion of the tongue muscles, strength of the tongue muscles, gag reflex and soft palate movement compared with before the intervention. Peak and inter-peak latencies had also improved significantly more in the observation than in the control group, on average.Conclusions:rTMS combined with conventional swallowing training can significantly improve the swallowing of dysphagic stroke survivors, and shorten the PL of the BAEP so as to better regulate deglutition.

10.3969/j.issn.2095-4344.2013.23.011