結膜涙囊鼻腔吻合術鼻内法

Endoscopic conjunctivo-dacryocystorhinostomy

要約　目的：結膜経由の涙囊鼻腔吻合術を鼻内法で行った2症例の報告。症例：症例は62歳の女性と59歳の男性で，いずれも片側の涙囊鼻腔吻合術鼻内法後の再閉塞に対し，結膜涙囊鼻腔吻合術を内視鏡を用いる鼻内法で行った。涙丘を切除し，鼻腔内吻合部までVランスで切開し，Jonesチューブを挿入し，長さを調整して縫合・固定した。5日後に鼻腔内に留置したガーゼを抜去し，通水が良好なことを確認して退院した。結論：結膜涙囊鼻腔吻合術は主として鼻外法で行われてきたが，鼻内法を応用すれば顔面を切らずに手術が可能であり，将来が期待される。

Abstract.　Purpose：To report two cases who received endoscopic conjunctivo-dacryocystorhinostomy. Cases：A 59-year-old male and a 62-year-old female underwent endoscopic conjunctivo-dacryocystorhinostomy for recurrence of unilateral stenosis of lacrimal passage after dacryocystorhinostomy. After excision of lacrimal caruncle, rhinostomy was made reaching the nasal cavity. Jones tube was inserted and fixated after adjusting the length. Patients were discharged 5 days later after the patency of lacrimal passage was ascertained. Conclusion：Endoscopic conjunctivo-dacryocystorhinostomy promises to be of value as it can be performed without incision to the face.