Clinical profile,imaging findings and endoscopic surgical treatment of acquired lacrimal sac mucocele / 中国内镜杂志

ABSTRACT

Objective To report the clinical features,imaging findings and endoscopic dacryocystosinostomy(En-DCR)of acquired lacrimal sac mucocele(ALSM).Methods 63 patients(63 eyes)with ALSM treated with En-DCR combined with bicanalicular silicone tube intubation from January 2016 to March 2021 were reviewed.The clinical features,imaging findings,and surgical treatment of the included patients were analyzed by preoperative examination and 12 month postoperative follow-up.Fifty-seven patients(21 males and 36 females)were enrolled in this study at last,including 30 right eyes and 27 left eyes,25～71 years old,with an average age of(52.89±11.66)years old.All eyes with history of epiphora and purulent secretion.Results CT examination revealed enlargement of the lacrimal sac,but no destruction of the adjacent bone.MRI imaging showed enlargement of the lacrimal sac,fluid collection separated from adjacent tissues by a thin rim,corresponding to mucocele in the sac and increase in the sac diameters in all analyzed cases.The mass was found to shrink significantly when the lacrimal sac was opened during the surgery,and the swelling was completely relieved within 7 days post-operation.After 12 months of follow-up,the anatomical success rate of En-DCR was 92.98%(53/57),the functional success rate was 89.47%(51/57),no complications such as mucocele recurrence,diminution of vision and infection were found.Conclusion All the patients with ALSM had a history of previous lacrimal duct obstruction.Imaging examinations are valuable for the diagnosis of ALSM.En-DCR for ALSM is safe and effective,and worthy of clinical promotion.