涙石を伴った涙道閉塞症例

Obstruction of lacrimal pathway by dacryoliths

涙石は涙道閉塞の原因になる。涙道手術の自験例179例のうち，9例で涙石が確認できた。すべて片側性で，男性4例，女性5例であり，年齢は33～85歳，平均64歳であった。涙石の存在部位は，涙小管と総涙小管が5例，涙囊が1例，鼻涙管が3例であった。治療では涙石の完全除去を目的とし，涙小管部の圧迫・洗浄・吸引，涙小管内のそう破，DCR鼻外法，DCR下鼻道法を単独または組み合わせて行い，全例で治癒することができた。また，涙道内視鏡と鼻内視鏡を活用して涙石を完全に除去することでNST挿入術が有効になる。

Dacryoliths may induce obstruction of the lacrimal passage. During lacrimal surgery on 179 cases,dacryolith was detected in 9 cases. All the 9 cases were unilaterally affected. The series comprised 4 males and 5 females. Their age ranged from 33 to 85 years,average 64 years. Dacryolith was located in the canaliculi or common canaliculus in 5 cases,in the lacrimal sac in one,and in the nasolacrimal duct in 3 cases. All the cases could be cured by surgical removal of dacryolith either by compression,irrigation/aspiration or curettage of canaliculus,external dacryocystorhinostomy（DCR）,or laser DCR via the inferior nasal meatus. Complete removal of dacryoliths using dacryoendoscope or nasal endoscope may facilitate insertion of nunchaku-style silicone tube（NST）.