The Surgical Outcome of Endoscopic Dacryocystorhinostomy According to the Obstruction Levels of Lacrimal Drainage System

최지철; 진홍률; 문영은; 김민상; 최미영; 심우섭; 오재광; 김현아

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자료유형: 학술저널

저자정보: 최지철 진홍률 문영은 김민상 최미영 심우섭 오재광 김현아

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제2권 제3호

발행연도: 2009.1

수록면: 141 - 144 (4page)

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Objectives. Many factors influence the outcome of endoscopic dacryocystorhinostomy (DCR). One of the most important prognostic factors is the level of obstruction in the lacrimal drainage system. The main objective of this report is to evaluate both the frequency of obstruction by anatomical region of the lacrimal drainage system on dacryocystography (DCG) and the surgical outcome of endoscopic DCR according to the obstruction level. Methods. A retrospective series of 48 patients (60 eyes) who had undergone endoscopic DCR from January 2005 to November 2007 were enrolled. Preoperative evaluation consisted of a standard examination which included lacrimal irrigation, probing, DCG and osteomeatal unit (OMU) computed tomography. Patients were classified into four groups according to the obstruction level on DCG. Surgical outcome was evaluated postoperatively by subjective improvement of epiphora and patent rhinostomy opening on nasal endoscopic exam. Results. Of 60 eyes, the levels of obstruction were the common canaliculus in 14 eyes (23.3%), the lacrimal sac in 13 eyes (21.7%), the duct-sac junction in 13 eyes (21.7%) and the nasolacrimal duct (NLD) in 20 eyes (33.3%). The ductsac junction obstruction was treated most successfully (100%), followed by NLD obstruction (90%), common canaliculus obstruction (78.6%) and saccal obstruction (69.2%). Conclusion. In patients with lacrimal drainage system obstruction, preoperative evaluation of obstruction level using DCG may be helpful for predicting the surgical outcome of endoscopic DCR. The saccal obstruction may have a worse prognosis than the other obstruction levels.

#Lacrimal sac #Lacrimal duct obstruction #Epiphora #Dacryocystorhinostomy

참고문헌 (13)

참고문헌 신청

Beigi B / 1998 / Dacryocystorhinostomy in south west England / Eye 12 : 358 ~ 362

Grover AK / 1991 / Modified canaliculo-dacryocystorhinostomy / Indian J Ophthalmol 39 (4) : 159 ~ 161

Hehar SS / 1997 / Endoscopic holmium:YAG laser dacryocystorhinostomy-safe and effective as a day-case procedure / J Laryngol Otol 111 (11) : 1056 ~ 1059

Hurwitz JJ / 1986 / Computerized survey of lacrimal surgery patients / Ophthalmology 93 (1) : 14 ~ 19

Kim JS / 2005 / Clinical evaluation and classification of nasolacrimal duct obstruction site by dacryocystography / J Korean Ophthalmol S 46 (2) : 191 ~ 195

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