軽度涙小管閉塞に対して施行した経鼻的涙囊鼻腔吻合術の手術成績

Outcome of endonasal dacryocystorhinostomy for mild canalicular obstruction

要約　背景：経鼻的涙囊鼻腔吻合術（DCR）の適応は，涙囊よりも後方の涙道閉塞であるとされてきた。筆者らは涙小管閉塞にもこれを応用している。目的：軽度の涙小管閉塞に対する経鼻的DCRの成績の報告。対象と方法：過去1年間に手術を行い，1年以上の経過が追跡できた軽度の涙小管閉塞35例を対象とした。男性10例，女性25例であり，16例には経鼻的DCR，19例には経皮的DCRを行った。術後1年目に通水試験，自覚症状などから成績を判定した。結果：全35例で涙道のステントチューブを留置できた。手術の成功率は，経鼻的DCRが69％，経皮的DCRが79％で，両群間に有意差はなかった（p＝0.25）。結論：軽度の涙小管閉塞に対する手術の成績は，経鼻的DCRと経皮的DCRとの間に差がない。

Abstract.　Background：Endonasal dacryocystorhinostomy（DCR）has been considered as indication for lacrimal obstruction farther to the lacrimal sac. We have been applying this method to canalicular obstruction. Purpose：To report the outcome of endonasal DCR for mild canalicular obstruction. Cases and Method：This retrospective study was made on 35 cases who received surgery for mild canalicular obstruction in the past one year and who were followed up for one year or longer. The series comprised 10 males and 25 females. Endonasal DCR was performed on 16 cases. External DCR was performed on 19 cases. Patients were evaluated for tear meniscus level,passage after lacrimal irrigation,and epiphora one year after surgery. Results：Surgery was evaluated as success in 11 cases（69％）after endonasal DCR and in 15 cases（79％）after external DCR. The difference was not significant（p＝0.25）. Conclusion：There is no difference in the rate of success between endonasal and external DCR for mild canalicular obstruction.