ABSTRACT
@#AIM: To investigate the effect and safety of endoscopic-assisted RS silicone intubation for congenital nasolacrimal duct obstruction after failed probing in children, in order to guide the clinical application.<p>METHODS: Retrospective case series. Totally 158 children(158 eyes)with congenital nasolacrimal duct obstruction who were failed probing in our hospital from September 2016 to September 2019 were selected as the research subjects. All patients underwent endoscopic-assisted RS silicone intubation. Regular follow-up was performed 1, 3, and 6mo after surgery. Observe the children's gender, age, treatment history, presence or absence of discharge before surgery; treatment effect; complications; types of nasolacrimal duct obstruction. Spearman's correlation coefficient calculation and analysis of the relationship between ages, times of probing and operation efficiency, Fisher's exact probability test for the operation efficiency of different types of nasolacrimal duct obstruction, and chi square test for the operation efficiency of presence or absence of discharge.<p>RESULTS: The total effective rate was 89.9%(142/158). The effective rate of surgery tends to decrease with age(Spearman's correlation coefficient <i>rs</i>= -1.000, <i>P</i><0.01). The effective rate of surgery showed a downward trend with the increase of the times of probing(Spearman's correlation coefficient <i>rs</i>= -1.000, <i>P</i><0.01). The efficiency of membranous nasolacrimal duct obstruction surgery is higher than that of complex nasolacrimal duct obstruction, and the difference is statistically significant(<i>P</i><0.05). It cannot be considered that there is a statistically significant difference in the effectiveness of the operation between the two symptoms with or without discharge(<i>P</i>>0.05). The main complications were: false passage formation(16 eyes, 10.1%), loss of tube(14 eyes, 8.9%), red eyes and irritated tears(18 eyes, 11.4%), punctums tissue adhesion(3 eyes, 1.9%), punctum granuloma formation(1 eye, 0.6%).<p>CONCLUSION: Endoscopic-assisted RS silicone intubation has a higher effective rate and better safety in the treatment of congenital nasolacrimal duct obstruction after failed probing in children. The effective rate of surgery decreases with age, and decreases with the increase of the times of probing. Membranous nasolacrimal duct obstruction is more effective than complicated nasolacrimal duct obstruction.
ABSTRACT
AIM: To investigate the effectiveness of minimally invasive conjunctivorhinostomy for complete bicanalicular obstruction, and to evaluate the advantages, complications, and degree of satisfaction after this technique. ●METHODS: Twenty - two patients ( 22 eyes ) with complete bicanalicular obstruction were selected as the research subjects, all patients were treated by minimally invasive conjunctivorhinostomy. The post - operation follow- up lasted for 3 - 27mo. Medical records were reviewed for demographic data, surgical time, length of the tubes, duration of follow-up, patency of the tube, postoperative complications, whether satisfied or dissatisfied with this procedure. Meanwhile, the data was analyzed for evaluating the clinical efficacy of minimally invasive conjunctivorhinostomy. ●RESULTS: The overall operative success rate was 95%(21/22), and the overall patient satisfaction was 68% (15/22 ) . The post - operation complications included:granulation tissue proliferation of the lower end of the tube 2 cases (9%), middle turbinate blocked the opening of tube 3 cases ( 14%) , nasal mucosa covering the opening of tube 1 case ( 5%) , the tube was blocked by secreta 5 cases ( 23%) , foreign body sensation 10 cases (45%), dry eye 2 cases ( 9%), regurgitation of nasal secreta discharge 8 cases (36%). ●CONCLUSION: Minimally invasive conjunctivorhinostomy can treat the complete bicanalicular obstruction. This operation method is characterized by simplicity, high success rate, short operative time, less tissue trauma, less complications, without facial scarring, and it is worth clinical promotion.
ABSTRACT
AIM: To analyze the pathogens and drug sensitivity of chronic dacryocystitis in order to provide evidence for clinical drug use. METHODS:Lacrimal secretion of 171 cases with chronic dacryocystitis was sampled for pathogenic bacteria culture identification and drug sensitivity test. Based on the results, the isolation rate of pathogens strains, the pathogens kind of chronic dacryoeystitis, main pathogens of chronic dacryocystitis, and sensitive drug for pathogens were analyzed. RESULTS: The isolation rate of pathogens strains was 76. 61% ( 131 cases ). The pathogens constituting the chronic dacryocystitis were predominantly gram-positive coccus,the percentage was 72. 52% (95 cases), among which staphylococcus hominis occupied 27. 48% ( 36 cases), staphylococcus epidermidis 16. 79% (22 cases), streptococcus viridans 12. 98% (17 cases). The majority of these bacteria were sensitive to cefoperazone-sulbactam, tobramycin, gentamicin and levofloxacin. For gram -positive coccus, cefoperazone - sulbactam, gentamicin and tobramycin were the most sensitive drug. For gram-negative bacilli, cefoperazone - sulbactam, tobramycin and levofloxacin were most sensitive drug. CONCLUSION: Staphylococcus hominis is the main pathogen of chronic dacryocystitis, tobramycin can be used as the first choice for local treatment of chronic dacryocystitis.