Name: transcanalicular diode laser-assisted dacryocystorhinostomy for the treatment of primary acquired nasolacrimal duct obstruction
Uploaded: 2017-10-13T12:30:00
Description: Watch this Scientific Journal Video about Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction at JoVE.com

德意志 Forschungsgemeinschaft (德国研究协会;为 2240 "(淋巴) 血管生成和细胞免疫在眼睛炎症性疾病" 到台基;他 6743/2-1 和他 6743/3-1 到台基), 科隆大学 GEROK 计划克尔克和台基。我们感谢 Dr. Kühner 的技术支持。

在这一过程中, 需要得到知情同意, 并已为在德国科隆科隆大学眼科科接受过手术的每一位患者获得了批准。所有检查和手术干预都是按照国家法律和1975年的赫尔辛基宣言在其当前版本中执行的. 
 注意: 除非另有说明, 否则指令将始终仅指执行过程的一侧。使用灭菌设备. 
 1. 患者准备 <ol> <li> 执行彻底的眼科检查 (特别注意眼睑、上、下泪和撕裂引流), ?...

<ol>
	<li>Toti, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nuovo+metodo+conservatoire+di+cura+radicale+delle+suppurazioni+croniche+del+sacco+lacrimale+(dacriocistorinostomia).">Nuovo metodo conservatoire di cura radicale delle suppurazioni croniche del sacco lacrimale (dacriocistorinostomia).</a> Clin. Mod. Pisa. 1 (10), 385-387 (1904).</li><li>Alnawaiseh, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-Term+Outcomes+of+External+Dacryocystorhinostomy+in+the+Age+of+Transcanalicular+Microendoscopic+Techniques.">Long-Term Outcomes of External Dacryocystorhinostomy in the Age of Transcanalicular Microendoscopic Techniques.</a> J. Ophthalmol. , (2016).</li><li>Tooley, A. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dacryocystorhinostomy+for+Acquired+Nasolacrimal+Duct+Stenosis+in+the+Elderly+(&#8805;80+Years+of+Age).">Dacryocystorhinostomy for Acquired Nasolacrimal Duct Stenosis in the Elderly (&#8805;80 Years of Age).</a> Ophthalmology. , (2016).</li><li>Detorakis, E. T., Drakonaki, E., Papadaki, E., Pallikaris, I. G., Tsilimbaris, M. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Watery+eye+following+patent+external+DCR:+an+MR+dacryocystography+study.">Watery eye following patent external DCR: an MR dacryocystography study.</a> Orbit. 29 (5), 239-243 (2010).</li><li>Kakizaki, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+lacrimal+canaliculus+and+sac+bordered+by+the+Horner's+muscle+form+the+functional+lacrimal+drainage+system.">The lacrimal canaliculus and sac bordered by the Horner's muscle form the functional lacrimal drainage system.</a> Ophthalmology. 112 (4), 710-716 (2005).</li><li>Emmerich, K. H., Ungerechts, R., Meyer-R&#252;senberg, H. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mikroendoskopische+Tr&#228;nenwegschirurgie.">Mikroendoskopische Tr&#228;nenwegschirurgie.</a> Ophthalmologe. 106 (3), 196-204 (2009).</li><li>Emmerich, K. H., L&#252;chtenberg, M., Meyer-R&#252;senberg, H. W., Steinhauer, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dacryoendoskopie+und+Laserdacryoplastik:+Technik+und+Ergebnisse.">Dacryoendoskopie und Laserdacryoplastik: Technik und Ergebnisse.</a> Klin. Monatsbl. Augenheilkd. 211 (6), 375-379 (1997).</li><li>Meyer-R&#252;senberg, H. W., Emmerich, K. H., L&#252;chtenberg, M., Steinhauer, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endoskopische+Laserdacryoplastik+-+Methodik+und+Ergebnisse+nach+3+Monaten.">Endoskopische Laserdacryoplastik - Methodik und Ergebnisse nach 3 Monaten.</a> Ophthalmologe. 96 (5), 332-334 (1999).</li><li>Emmerich, K. H., Ungerechts, R., Meyer-R&#252;senberg, H. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcanalicular+microendoscopic+laser+DCR:+technique+and+results.">Transcanalicular microendoscopic laser DCR: technique and results.</a> Klin Monbl Augenheilkd. 229 (1), 39-41 (2012).</li><li>Koch, K. R., Cursiefen, C., Heindl, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcanalicular+Laser+Dacryocystorhinostomy:+One-Year-Experience+in+the+Treatment+of+Acquired+Nasolacrimal+Duct+Obstructions.">Transcanalicular Laser Dacryocystorhinostomy: One-Year-Experience in the Treatment of Acquired Nasolacrimal Duct Obstructions.</a> Klin. Monbl. Augenheilkd. 233 (2), 182-186 (2016).</li><li>Koch, K. R., K&#252;hner, H., Cursiefen, C., Heindl, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Significance+of+transcanalicular+laser+assisted+dacryocystorhinostomy+in+modern+lacrimal+drainage+surgery.">Significance of transcanalicular laser assisted dacryocystorhinostomy in modern lacrimal drainage surgery.</a> Ophthalmologe. 112 (2), 122-126 (2015).</li><li>Uludag, G., Yeniad, B., Ceylan, E., Yildiz-Tas, A., Kozer-Bilgin, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Outcome+comparison+between+transcanalicular+and+external+dacryocystorhinostomy.">Outcome comparison between transcanalicular and external dacryocystorhinostomy.</a> Int. J. Ophthalmol. 8 (2), 353-357 (2015).</li><li>Ozcimen, M., Uysal, I. O., Eryilmaz, M. A., Kal, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endocanalicular+diode+laser+dacryocystorhinostomy+for+nasolacrimal+duct+obstruction:+short-term+results+of+a+new+minimally+invasive+surgical+technique.">Endocanalicular diode laser dacryocystorhinostomy for nasolacrimal duct obstruction: short-term results of a new minimally invasive surgical technique.</a> J. Craniofac. Surg. 21 (6), 1932-1934 (2010).</li><li>Drnovsek-Olup, B., Beltram, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcanalicular+diode+laser-assisted+dacryocystorhinostomy.">Transcanalicular diode laser-assisted dacryocystorhinostomy.</a> Indian. J. Ophthalmol. 58 (3), 213-217 (2010).</li><li>D'Ecclesia, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endoscopic+laser-assisted+dacryocistorhinostomy+DCR+with+the+placement+of+a+customised+silicone+and+Teflon+bicanalicular+stent+Endoscopic+laser-assisted+dacryocystorhinostomy+(DCR).">Endoscopic laser-assisted dacryocistorhinostomy DCR with the placement of a customised silicone and Teflon bicanalicular stent Endoscopic laser-assisted dacryocystorhinostomy (DCR).</a> Clin. Ter. 165 (6), e391-e394 (2014).</li><li>Ayintap, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+age+as+a+possible+prognostic+factor+for+transcanalicular+multidiode+laser+dacryocystorhinostomy.">Analysis of age as a possible prognostic factor for transcanalicular multidiode laser dacryocystorhinostomy.</a> J. Ophthalmol. , (2014).</li><li>Dogan, R., Meric, A., Ozs&#252;tc&#252;, M., Yenigun, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diode+laser-assisted+endoscopic+dacryocystorhinostomy:+a+comparison+of+three+different+combinations+of+adjunctive+procedures.">Diode laser-assisted endoscopic dacryocystorhinostomy: a comparison of three different combinations of adjunctive procedures.</a> Eur. Arch. Otorhinolaryngol. 270 (8), 2255-2261 (2013).</li><li>Plaza, G., Beter&#233;, F., Nogueira, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcanalicular+dacryocystorhinostomy+with+diode+laser:+long-term+results.">Transcanalicular dacryocystorhinostomy with diode laser: long-term results.</a> Ophthal Plast Reconstr Surg. 23 (3), 179-182 (2007).</li><li>Heindl, L. M., Junemann, A., Holbach, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+clinicopathologic+study+of+nasal+mucosa+in+350+patients+with+external+dacryocystorhinostomy.">A clinicopathologic study of nasal mucosa in 350 patients with external dacryocystorhinostomy.</a> Orbit. 28 (1), 7-11 (2009).</li><li>Heindl, L. M., Treutlein, E., J&#252;nemann, A. G., Kruse, F. E., Holbach, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Selective+lacrimal+sac+biopsy+for+external+dacryocystorhinostomy:+a+clinical+pathological+study.">Selective lacrimal sac biopsy for external dacryocystorhinostomy: a clinical pathological study.</a> Ophthalmologe. 107 (12), 1139-1144 (2010).</li><li>Aziz, T., Biron, V. L., Ansari, K., Flores-Mir, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measurement+tools+for+the+diagnosis+of+nasal+septal+deviation:+a+systematic+review.">Measurement tools for the diagnosis of nasal septal deviation: a systematic review.</a> J Otolaryngol Head Neck Surg. 43, 11 (2014).</li><li>von Goscinski, C., Koch, K. R., Cursiefen, C., Heindl, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tumors+of+the+lacrimal+drainage+system.">Tumors of the lacrimal drainage system.</a> HNO. 64 (6), 386-393 (2016).</li><li>Heindl, L. M., J&#252;nemann, A. G., Kruse, F. E., Holbach, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tumors+of+the+lacrimal+drainage+system.">Tumors of the lacrimal drainage system.</a> Orbit. 29 (5), 298-306 (2010).</li><li>Kaynak, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcanalicular+diode+laser+assisted+dacryocystorhinostomy+in+primary+acquired+nasolacrimal+duct+obstruction:+2-year+follow+up.">Transcanalicular diode laser assisted dacryocystorhinostomy in primary acquired nasolacrimal duct obstruction: 2-year follow up.</a> Ophthal Plast Reconstr Surg. 30 (1), 28-33 (2014).</li><li>Goel, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcanalicular+Laser-Assisted+Dacryocystorhinostomy+With+Endonasal+Augmentation+in+Primary+Nasolacrimal+Duct+Obstruction:+Our+Experience.">Transcanalicular Laser-Assisted Dacryocystorhinostomy With Endonasal Augmentation in Primary Nasolacrimal Duct Obstruction: Our Experience.</a> Ophthal Plast Reconstr Surg. , (2016).</li><li>Yildirim, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+Transcanalicular+Multidiode+Laser+Dacryocystorhinostomy+with+and+without+Silicon+Tube+Intubation.">Comparison of Transcanalicular Multidiode Laser Dacryocystorhinostomy with and without Silicon Tube Intubation.</a> J Ophthalmol. , (2016).</li><li>Kar, T., Yildirim, Y., Topal, T., &#199;olako&#287;lu, K., &#220;nal, M. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+adjunctive+mitomycin+C+in+transcanalicular+diode+laser+dacryocystorhinostomy+in+different+age+groups.">Efficacy of adjunctive mitomycin C in transcanalicular diode laser dacryocystorhinostomy in different age groups.</a> Eur. J. Ophthalmol. 26 (1), 1-5 (2016).</li><li>Ozsutcu, M., Balci, O., Tanriverdi, C., Demirci, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+adjunctive+mitomycin+C+in+transcanalicular+diode+laser+dacryocystorhinostomy.">Efficacy of adjunctive mitomycin C in transcanalicular diode laser dacryocystorhinostomy.</a> Eur. Arch. Otorhinolaryngol. 274 (2), 873-877 (2016).</li></ol>

Transcanalicular 激光辅助 DCR 如上所述是一个相当快速, 微创的方式来治疗绝对 infrasaccal 鼻泪管阻塞有效地不需要皮肤切口, 从而节省不仅皮肤, 而且内侧眦肌腱和生理小泵的机理。虽然该程序非常适合于患有鼻泪管阻塞的患者, 但非特发性狭窄的病症不符合此程序。这是由于, 部分, 因为它不允许全面检查泪腺囊或活检不典型的结果是采取19,20,<sup cl...

Infrasaccal 原发性后天性鼻泪管阻塞 (潘多) 是一种常见的疾病, 在 middle-aged 和老年患者导致慢性溢和睑, 以及复发或慢性泪囊炎。最常见的情况是, 患者会出现一个或两个鼻泪导管的 infrasaccal 阻塞, 导致泪液引流不足。
在治疗潘多, 外部泪囊鼻腔切除术 (DCR) 仍然被认为是金标准, 尽管这个过程历史上追溯到100年前, 当它是第一次执行1。经皮下切口和泪囊鼻壁的制备, 用钻头制造出通向鼻腔的骨口, 绕过阻塞的导管。已报告此方法2,3的功能成功率超过85%。然而, 这些结果是以执行一个相对侵入性的手术的成本来承担风险的眼睑的内侧结构包括生理小泵机制4,5 , 并可能给患者留下不受欢迎的疤痕, 虽然现代 nasojugal 皮肤切口有改善的结果。这些风险是潜在的可避免通过执行较少侵入技术或选择一个鼻的方法。
为了规避侵入性手术, 在微创泪流再通领域做了大量的工作。两种方法, 特别是建立了潜在的第一步程序: microdrill dacryoplasty 和激光辅助 dacryoplasty。这些程序是基于 transcanalicular 内窥镜的泪引流系统, 可以执行治疗段膜狭窄的鼻泪管。虽然只有微创和特点的快速 reconvalescence, 这些正值技术的共同缺点是相对较低的功能成功率关于长期的结果6,7,8,9。
为了填补这些第一步程序和外部 DCR 之间的空白, 作为一种明确的治疗方法, 最近已经制定了新的办法。最有希望的是激光辅助 DCR 治疗绝对 infrasaccal 潘多。像所有上述的方法, 病人建议被置于全身麻醉的程序。二极管激光纤维通过小插入, 然后进入泪囊。接下来, 将激光能量应用到侧鼻壁上, 直到形成一个骨口, 在中鼻甲的前边缘的高度连接到鼻腔,10,11。持续的视觉控制一直使用鼻内窥镜。新形成的吻合口用作泪引流的旁路。成功的灌溉后, bicanalicular 硅插管, 以防止早期疤痕的新形成的口。术后治疗包括充血、甾体和抗生素滴眼液, 分别预防肿胀、炎症和感染。
手术时间和 reconvalescence 一般短于外部 DCR (10-25 分钟的激光辅助 DCR vs 35-75 分钟外 DCR)。并发症率较低, 最常见的是离散肿胀的眼睑和硅胶管脱垂。小感染和热损伤是罕见的事件10。一年功能成功率为 74-88% 已报告10,11,12,13,14,15,16, 17,18, 因此在外部 DCR 的后面, 不受外部手术方法的不利因素的困扰。然而, 长期的结果仍有待提供。此外, 即使在激光辅助 DCR 失败后, 次级外部 DCR 仍然可以执行, 没有困难。因此, 激光辅助 DCR 有资格作为一个可行的第二步的程序, 应最好地进行后再通手术失败和外部 DCR。

<table border="0" cellpadding="0" cellspacing="0" width="812">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">C1.multi</td>
			<td style="width:281px;">LUT</td>
			<td style="width:119px;">05.0082h.1</td>
			<td style="width:196px;">Endoscope camera</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">HL 250</td>
			<td style="width:281px;">LUT</td>
			<td style="width:119px;">95.2048n</td>
			<td>Endoscope light source</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">MD-19E</td>
			<td style="width:281px;">ACL GmbH</td>
			<td style="width:119px;">1119</td>
			<td>Endoscope screen</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">FOX (laser)</td>
			<td style="width:281px;">A.R.C. Laser GmBH, N&#252;rnberg, Germany</td>
			<td style="width:119px;">n/a</td>
			<td>Diode laser</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Laser fiber</td>
			<td style="width:281px;">A.R.C. Laser GmBH, N&#252;rnberg, Germany</td>
			<td style="width:119px;">LL13001s</td>
			<td>Laser fiber</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:216px;">Laser handpiece</td>
			<td style="width:281px;">A.R.C. Laser GmBH, N&#252;rnberg, Germany</td>
			<td style="width:119px;">n/a</td>
			<td>Handpiece</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Wide Collarette Monoka</td>
			<td style="width:281px;">Fa. FCL, Paris, France</td>
			<td style="width:119px;">S1.1630</td>
			<td>monocanalicular silicon tube</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Suction elevatorium</td>
			<td style="width:281px;">Storz</td>
			<td style="width:119px;">474015</td>
			<td>For intranasal use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Forceps (Gr&#252;nwald)</td>
			<td style="width:281px;">Storz</td>
			<td style="width:119px;">426620</td>
			<td>For intranasal use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Forceps (Blakesley-Wilde)</td>
			<td style="width:281px;">Storz</td>
			<td style="width:119px;">456502</td>
			<td>To grab the silicon tube</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Lacrimal canula</td>
			<td style="width:281px;">Storz</td>
			<td style="width:119px;">81071</td>
			<td>Blunt cannula</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Bangerter probe cannula</td>
			<td style="width:281px;">Storz</td>
			<td style="width:119px;">81055</td>
			<td>Bangerter probe cannula</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Wooden spatula</td>
			<td style="width:281px;">any</td>
			<td style="width:119px;">n/a</td>
			<td>Wooden spatula</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Xylometazolin 0.05% eye drops</td>
			<td>GlaxoSmithKline Consumer Healthcare</td>
			<td style="width:119px;">n/a</td>
			<td>Decongestant eye drops</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Dexapos comod eye drops</td>
			<td style="width:281px;">Ursapharm</td>
			<td style="width:119px;">n/a</td>
			<td>steroid eye drops</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Floxal eye drops</td>
			<td style="width:281px;">Dr. Gerhard Mann</td>
			<td style="width:119px;">n/a</td>
			<td>antibiotic eye drops</td>
		</tr>
	</tbody>
</table>

transcanalicular diode laser-assisted dacryocystorhinostomy for the treatment of primary acquired nasolacrimal duct obstruction

今天的金标准在治疗 infrasaccal 原发性后天性鼻泪管阻塞 (潘多) 是外部泪囊鼻腔切除术 (DCR), 一个相对侵入的程序, 可以执行后, 失败的正值治疗。然而, 随着二极管激光技术领域的进步, 新的方法已经出现。激光辅助 transcanalicular DCR 与后续 bicanalicular 硅插管是一个新的选择, 显示了巨大的承诺作为一个可行的微创手术。在鼻腔的永久性内窥镜视觉控制下, 将一根二极管激光纤维插入泪囊, 应用激光能量在泪腺囊和鼻腔之间形成一个骨口。由于不需要做皮肤切口, 这种方法的优点包括皮肤的保留, 以及内侧眼睑结构和生理眼睑-小泵机构。手术时间和 reconvalescence 一般短于外 DCR。并发症包括硅胶管脱垂, 轻度肿胀, 很少, 小感染和热损伤。一年的功能成功率, 定义为完全解决症状和口通畅, 是高, 但仍然在后面的外部 DCR。但是, 在激光辅助 DCR 失败后的二次外部 DCR 可以毫不费力地进行。因此, 激光辅助 transcanalicular DCR 是一个有效的选择, 应考虑作为第二步的过程后, 再通程序的失败和外部 DCR。

最佳结果:
上述过程大约需要 10-25 分钟, 而且通常是很好的耐受。第二天检查后, 大约60% 的病例会出现眼睑肿胀。这种小肿块总是在最多三天内完全解决。患者不抱怨疼痛, 硅脱垂或受伤或感染的迹象。然而, 由于 bicanalicular 硅插管正在执行过程中, 溢可能坚持, 直到管被删除。局部应用抗生素, 甾体, 充血眼术后是必要的, 病人需?...

Watch this Scientific Journal Video about Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction at JoVE.com

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

本议定书的目的是提出 transcanalicular 激光辅助泪囊鼻腔吻合术作为一种微创方法治疗原发性后天性鼻泪管阻塞。

Transcanalicular 二极管激光辅助泪囊鼻腔吻合术治疗原发性鼻泪管阻塞

Today&#39;s gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), ...

Research

JoVE Journal

Medicine

Thermal Ablation for the Treatment of Abdominal Tumors

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Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ...

科研

医学

Cannulation of the Mouse Submandibular Salivary Gland via the Wharton's Duct

沃顿商学院的导管插管通过小鼠颌下腺唾液腺

Severe salivary gland hypofunction is frequently found in patients with Sj&ouml;gren's syndrome and those who receiving therapeutic 
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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

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Psoriasis is a  chronic, immune-mediated inflammatory skin disease affecting approximately 2-3%  of the population. The Goeckerman regimen consists of ...

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

评价一种新型激光辅助冠状动脉吻合口连接器 - 三位一体夹 - 在猪非体外循环旁路模式

To simplify and facilitate beating heart (i.e., off-pump), minimally invasive coronary artery bypass surgery, a new coronary anastomotic connector, the ...

A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction

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Obstruction of the kidney may affect native or transplanted kidneys and results in kidney injury and scarring. Presented here is a model of obstructive ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

Nerve-sparing Mid-urethral Obstruction (NeMO) in Female Small Rodents

Nerve-sparing Mid-urethral Obstruction NeMO in Female Small Rodents

在女小鼠害保留神经的中期尿道梗阻（NEMO）

Partial bladder outlet obstruction (pBOO) has a high prevalence, causes significant patient burden, and immense health care costs. The most common animal ...

Development of a Noninvasive, Laser-Assisted Experimental Model of Corneal Endothelial Cell Loss

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Nd:YAG lasers have been used to perform noninvasive intraocular surgery, such as capsulotomy for several decades now. The incisive effect relies on the ...

Establishment of a Mouse Severe Acute Pancreatitis Model using Retrograde Injection of Sodium Taurocholate into the Biliopancreatic Duct

建立小鼠重症急性胰腺炎模型，将牛磺胆酸钠逆行注射到胆胰管中

The prevalence of acute pancreatitis (AP), especially severe acute pancreatitis (SAP), is increasing in younger age groups annually. However, there is a ...

Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors

腹腔镜-内镜合作手术治疗胃肠道间质瘤

In view of the shortcomings of endoscopic or laparoscopic surgeries alone in the treatment of gastric gastrointestinal stromal tumors (G-GISTs), this ...