鼻涙管閉塞に対するヌンチャク型シリコンチューブを用いた涙道内シリコンチューブ留置術の効果

Treatment of nasolacrimal duct obstruction by intubation of U-shaped silicone tube

（17-G409-8）　ヌンチャク型シリコンチューブ（nunchaku-style silicone tubing：N-ST）を用いた涙道内シリコンチューブ留置術（direct silicone intubation：DSI）の鼻涙管閉塞への適応を検討した。鼻涙管閉塞20例にN-STによるDSIを行い，70％の症例で治癒した。これは涙嚢鼻腔吻合術（dacryOcystorhinosto-my：DCR）82例の成功率83.9％よりは低いが，涙小管閉塞型24例へのN-STによるDSIの成功率75％とほぼ同じであり，DCRと比べて術中術後の鼻出血が少ないこと，手術時間の短さから鼻涙管閉塞への第一選択治療になりうると考えた。

We treated 44 cases of nasolacrimal duct obstruction by dilatation of lacrimal puncta followed by retention of a U-shaped silicone tube for 1 to 4 months. The U-shaped silicone tube is actually two tubes connected by a cord. Cure was obtained in 32 cases (73% ) . In another series of 62 similar cases, cure was obtained in 52 cases (84%) by dacryocystorhinostomy (DCR). The former method is recommended as the first choice for nasolacrimal duct obstruction because of shorter duration of surgery and lesser incidence of intra -and postoperative nasal hemorrhage.