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目的探讨鼻内镜下鼻腔泪囊造口术的泪囊鼻内表面定位。方法对15具(30侧)成人尸头的泪囊在鼻腔外侧壁上的投影位置进行解剖学测量;并指导临床应用于32例(39侧)慢性泪囊炎鼻泪管阻塞患者的鼻内镜下鼻腔泪囊造口术。结果解剖学测量泪囊大部分(2／3)位于中鼻甲腋上方,小部分(1／3)位于中鼻甲腋下方;泪囊大部分(2／3)位于总泪小管口下方,小部分(1／3)位于总泪小管口上方;内眦韧带横压于泪囊的中部,几乎与总泪小管平行。施行手术的32例(39侧),术后随访半年以上,治愈28例(35侧,89．8％),好转2例(2侧,5．1％),无效2例(2侧,5．1％),总有效率94．9％。结论以中鼻甲腋前上0．2 cm为手术造口中心点,中鼻甲腋前上0．8 cm为上界,腋前下0．4 cm为下界,作弧形黏膜切口及1．2 cm×1．0 cm骨孔,此为鼻腔泪囊造口的最佳位置;利用枪状镊依据鼻外内眦韧带定位泪囊造口的中心点亦不失为一简易可取的方法。
Objective To investigate the nasal endoscopic dacryocystorhinostomy under nasal endoscopic dacryocystorhinostomy. Methods Anatomical measurements of the projection of dacryocyst on the nasal cavity were performed on 15 (30) adult cadaver heads. The clinical application was performed in 32 patients (39 sides) with intranasal nasal drainage of nasolacrimal duct obstruction Microscopic nasal dacryocystorhinostomy. Results Anatomical measurements Most of the dacryocyst (2/3) was located above the middle turbinate axilla, a small part (1/3) was located below the middle turbinate axillary; most of the dacryocyst (2/3) (1/3) is located above the total small lacrimal duct; the ligament of the medial fossa transverse pressure in the middle of the lacrimal sac, almost parallel with the canaliculus. Thirty-two cases (39 sides) underwent surgery, followed up for more than six months. 28 cases (35.8%) were cured, 2 cases improved (5.1%), and 2 cases .1%), the total efficiency of 94.9%. Conclusions In the middle turbinate, the anteroposterior 0.2 cm is the center of operation ostomy, the middle axillary upper 0.8 cm is the upper bound, the anterior axillary 0.4 cm is the lower bound, and the curved mucosa incision and 1.2 cm × 1.0 cm bone hole, which is the best location for nasal lacrimal sac stoma; the use of gun-shaped tweezers according to the location of the epiphysis ligament lacrimal sac ostomy central point is a simple and desirable method.