鼻内镜及影像学定位在鼻腔泪囊造口术中的应用.pdfVIP

中国耳鼻咽喉头颈外科／2007年12月，第14卷，第12期 鼻内镜及影像学定位在鼻腔泪囊造口术中的应用 时文杰’，王学敏 ，陈志良’，张玉庚’，孙沛勇’，王晓非’ (1天津市第一中心医院耳鼻咽喉头颈外科，天津 300192；2解放军第四六四医院眼科，天津 300192) 【摘 要】 目的 探讨鼻内泪囊的解剖及影像学定位在泪 value of image stereotactic technique in Iocalization of 囊手术中的临床应用价值。方法 对2O例 (26眼)慢性 the lacrimal sac in endoscopic dacryocystorhinostomy． 泪囊炎患者术前进行CT~,R囊造影三维重建，确定泪囊大 METHODS Preoperative dacryocyst iodized O-l 小及影像学定位；术中以上颔线作为定位开放泪囊的参 opacification CT 3D—recOnstructiOn were performed 考标志，行鼻内镜下鼻腔泪囊造口术。结果 CT~,R囊造 in 2O cases(26 eyes)with chronic dacryocystitis 影片能清晰显示泪囊大小以及与周围结构的关系，并可 in order to estimate the Size of IacrimaI sac and 任意径线及角度适时测量。术中以上颔线作为手术进路 conform image IocaIization．The max…ary IiRe was 的标志均能准确开放泪囊，20例 (23眼)中，大泪囊1 0 considered as a labeling mark during operation． 眼术后无造口闭塞，治愈率1OO％；中泪囊11眼术后有1 RESULTS The size of IacrimaI passage COUId be 眼仍有少量流泪，但较术前明显好转，治愈率9O．9％； displayed with dacryocyst iodized oil opacification CT and 小泪囊2眼中有1眼术后仍有明显流泪，内镜检查发现造 the relation between IacrimaI sac and structures around 口粘连、阻塞，治愈率5O％。结论 术前计算机三维重 it could be observed and measured freely．In endoscopic 建泪囊造影对鼻内镜下鼻腔泪囊造口术具有重要应用价 dacryocystorhinostomy．IacrimaI sac was opened 值。上颔线可以作为泪囊手术进路的参考标志之一。 correctly with maxillary line as a mark．Ten eyes with big 【关键词】 内窥镜检查；成像，三维；泪囊鼻腔吻合术 IacrimaI sac had unobstructed stoma．and the cured rate was reached to 1OO％：ORe of 1 1 eyes with moderate Application of endoscopy and image stereotactic IacrimaI sac stilI have slight Iacrimation after operation， technique in dacryocystorhinostomy but obviously improved compared with preoperation， SHI Wenjie’，WANG Xuemin ，CHEN Zh#~ng’，ZHANG the cured rate in patients with moderate IacrimaI sac Yugeng’SUN Pe~ong’，WANG Xiaofei’ was 90．9％．In 2 eyes with smalllacrimaI sac．1 eye