総涙小管閉塞に対する内視鏡直接穿破法および涙管チューブ挿入術の治療成績

Outcome of probing and lacrimal intubation under endoscopic observation for common canalicular obstruction

要約　目的：総涙小管閉塞に対し，内視鏡下での直接穿破法と涙管チューブ挿入術の短期成績の報告。症例と方法：総涙小管閉塞がある22例27側に内視鏡下での直接穿破法と涙管チューブ挿入術を行った。男性6例，女性16例で，年齢は58～86歳（平均71歳）である。術後の経過は6か月以上観察した。結果：27側中24側（89％）でチューブ挿入ができ，挿入できた症例での手術時間は平均14分であった。チューブ抜去後の涙道開存率は24側中23側（96％）であった。1側では抜去後13か月で鼻涙管閉塞が再発し，同治療を再び行った。結論：総涙小管閉塞に対する内視鏡下での直接穿破法と涙管チューブ挿入術は，短時間で行うことができ，術後成績も良好であった。

Abstract.　Purpose：To report the outcome of probing and intubation under endoscopic observation for obstructed common lacrimal duct. Cases and Method：This study was made on 27 sides of 22 cases who were diagnosed with obstruction of common lacrimal duct. The series comprised 6 males and 16 females. The age ranged from 58 to 86 years, average 71 years. Cases were followed up for 6 months or longer. Results：Intubation was possible on 24 out of 27 sides（89％）. It took an average of 14 minutes for intubation. Lacrimal passage was patent in 23 out of 24 sides（96％）after removal of lacrimal tube. One side developed obstruction of nasolacrimal duct 13 months after tube removal. The obstruction was treated again by the same method. Conclusion：Probing and intubation under endoscopic observation could be performed easily and resulted in good outcome for obstruction of common lacrimal duct.