RESUMEN
·AIM:To investigate the therapeutic effect of endoscopic dacryocystorhinostomy in the treatment of acute dacryocystitis.·METHODS: Totally 55 patients with acute dacryocystitis was divided into two groups according to the clinical manifestations:the group of redness and swelling and the group of abscess rupture. The bleeding and pain after operation were observed. Operation effect and skin scar of lacrimal sac area was observed and compared between two groups.·RESULTS: The patients were followed up from 3mo to 2a, and effective rates of the two groups of patients were compared, which showed no statistically significant difference ( x2 = 0. 307, P> 0. 05 ). Surgery before the abscess ruptured had the minimal impact on the appearance. The appearance impact of the group of abscess rupture was higher than that of the group of redness, and there are statistically significant difference (x2=12. 44, P<0. 05).·CONCLUSION:Endonasal endoscopic dacryocystorhinostomy is an effective method on the treatment of acute dacryocystitis. Early surgery has the advantages of quick recovery, scarlessness and high efficiency. Therefore, it worthy of clinical promotion.
RESUMEN
Objective To provide the endoscopic anatomic basis and anatomic parameters for endoscopic surgical therapy on orbital lesions , and to analyze the advantages and key points of this surgical approach .Methods Five fresh adult heads were used in this experiment .Endonasal thanslamina approach and endoscopic technique were applied to observe important anatomic marks while intraoperative medicalization of the medical rectus muscle was applied to observe the exposure and positioning of important structures and trends of the optic canal and intra orbit .Results Uncinate process was at the lower front corner of middle nasal concha; ethmoidalis bulla was behind the uncinate process , and ethmoidei sinus was reachable after an incision was made on ethmoidalis bulla;anterior ethmoidal artery and posterior ethmoidal artery were the important anatomic landmarks of the inner ethmoidei sinus;optic canal prominence , carotid artery prominence and OCR were the important anatomic landmarks of the inner sphenoid sinus; lamina papyracea was at the lateral wall of ethmoidei sinus , and orbital contents were approacchable after lamina papyracea was cut off ;inside orbit , the optic nerve was approachable through the gap between the medial rectus muscle and inferior rectus muscle .The ophthalmic artery of 9 out of 10 sides of the specimens was originated from the supraclinoidal segment of the internal carotid artery while the remaining one was originated from the cavernous segment of internal carotid artery .There were 7 sides in which ophthalmic artery was located at the inferior lateral of the optic nerve;there were 2 sides in which ophthalmic artery was located at the inferior of the optic nerve; the remaining one was located at the inferior medial of the optic nerve .Conclusion The endoscopic endonasal thanslamina approach can sufficiently expose the optic nerve and the structures in the medical space of the orbit.Uncinate process, ethmoid bulla, anterior ethmoidal artery, posterior ethmoidal artery and posterior ethmoid sinus are the important landmarks of the endoscopic endonasal thanslamina approach .Optic canal prominence , internal carotid artery prominence and OCR are the important landmarks for optic canal decompression .Ophthalmic artery , orbital branches , anterior ethmoidal artery , posterior ethmoidal artery , internal carotid artery are the important vessels . Medialization of the medial rectus muscle is effective to approach the orbital anatomical structures .