涙管チューブ留置術を施行した涙囊炎症例の経過

Outcome of tube implantation for dacryocystitis

要約　目的：慢性涙囊炎に対するチューブ留置術後の経過と成績に影響する因子の報告。対象と方法：慢性涙囊炎に対してチューブを留置した22例24側を対象とした。涙道内視鏡下で閉塞部の同定と穿破を行い，涙囊を洗浄した。男性4例4側，女性18例20側で，年齢は27〜85歳，平均65歳である。定期的な通水のみで流涙と眼脂が少ない症例を成功例，流涙が軽減しても眼脂が残り，涙囊鼻腔吻合術を希望した症例を不成功例とした。チューブ抜去後1年以上の経過を観察した。結果：成功例は7例7側で，16例17側が不成功例であった。不成功例では鼻涙管下部の閉塞が有意に多かった。不成功例では涙囊鼻腔吻合術を9例10側に行い，全例で流涙と眼脂が消失した。結論：慢性涙囊炎に対するチューブ留置術で，30％の症例で流涙と眼脂が消失した。不成功例では鼻涙管下部の閉塞が有意に多かった。

Abstract.　Purpose：To report the long-term outcome of intubation for chronic dacryocystitis and factors related to success. Cases and Method：This retrospective study was made on 24 sides of 22 cases who received intubation for chronic dacryocystitis. An endoscope was used to identify and perforate the site of nasolacrimal obstruction. The series comprised 4 sites of 4 males and 20 sites of 18 females. The age ranged from 27 to 85 years and averaged 65 years. Cases were categorized as success that showed no lacrimation and discharge one year after removal of tubing. Results：Seven sites of 7 cases were evaluated as success and 17 sites of 16 cases as failure. Cases evaluated as failure showed a significantly higher incidence of obstruction at the lower nasolacrimal duct. Eventual dacryocystorhinostomy was performed on 10 sites of 9 cases and resulted in success in all the cases. Conclusion：Intubation for chronic dacryocystitis was successful in 30％ of cases. Unsuccessful cases showed a significantly higher incidence of obstruction at the lower nasolacrimal duct.