射频技术37246.docVIP

Disclaimer: The information contained within the Grand Rounds Archive is intended for use by doctors and other health care professionals. These documents were prepared by resident physicians for presentation and discussion at a conference held at Baylor College of Medicine in Houston, Texas. No guarantees are made with respect to accuracy or timeliness of this material. This material should not be used as a basis for treatment decisions, and is not a substitute for professional consultation and/or peer-reviewed medical literature. Endoscopic DacryocystorhinostomyJune 1, 2000Allen Lue, M.D.Endoscopic dacryocystorhinostomy or DCR has traditionally been performed for nasolacrimal duct obstruction via an external approach, although the procedure is actually uniquely suited for an endoscopic approach.The first reported dacryocystectomy was performed by Celsus in 50 AD. This was probably done for a tumor. Galenas of Pergamos was reportedly the next person to perform a surgery on the lacrimal sac. He performed a medial canthal incision and cauterized with molten lead. Anel in the 1700s was the first to irrigate the lacrimal duct for this symptom of obstruction. Bowman in the 1800s later reported the technique of actually putting a probe through the duct to relieve obstruction of the nasolacrimal system. Toti, an Italian in 1904, was really the first person to perform external dacryocystorhinostomy for obstruction. He made an incision through the skin and created a new ostium between the nasolacrimal sack and the nose. By removing this bone, drainage to the nose was allowed through bypassing any obstruction distally. His technique is still being used today and is generally thought of as the gold standard for surgery of nasolacrimal duct obstruction. In 1895, Caldwell reported his experience with the endonasal approach but showed mediocre results and so the external procedure was used for quite some time. However, Rice in 1990 reported his experience using endoscopic i