AIM:To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy(EN-DCR).METHODS:This retrospective compara...AIM:To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy(EN-DCR).METHODS:This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients.Computed tomographic-dacryocystography(CT-DCG)scans were performed before lacrimal surgery,and image reconstruction was used to obtain continuous 0.75-mm axial,coronal,and segmental sections for review.The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement,as well as the obstructed location.RESULTS:The height of the lacrimal sac was 12.99±2.10 mm in this study.The operculum of the middle turbinate(OMT)was located vertically in the lower third of the lacrimal sac.Horizontally,the junction between the maxillary bone and the lacrimal bone(MB-LB)was close to,mostly(60.2%)posterior to,the lacrimal sac.The uncinate process was more frequently attached to the lacrimal bones(75.1%).The obstructions were generally located around the entrance of the nasolacrimal duct(NLD).However,some were placed higher,with 7.63%blocked not lower than the OMT.There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction(r=-0.35,P<0.01).CONCLUSION:In this study,the OMT and MB-LB can be served as the landmarks in EN-DCR.Partial uncinectomy should be performed in most cases.The obstructions were generally located around the entrance of the NLD,but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery.展开更多
基金Supported by the National Natural Science Foundation of China(No.81700807).
文摘AIM:To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy(EN-DCR).METHODS:This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients.Computed tomographic-dacryocystography(CT-DCG)scans were performed before lacrimal surgery,and image reconstruction was used to obtain continuous 0.75-mm axial,coronal,and segmental sections for review.The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement,as well as the obstructed location.RESULTS:The height of the lacrimal sac was 12.99±2.10 mm in this study.The operculum of the middle turbinate(OMT)was located vertically in the lower third of the lacrimal sac.Horizontally,the junction between the maxillary bone and the lacrimal bone(MB-LB)was close to,mostly(60.2%)posterior to,the lacrimal sac.The uncinate process was more frequently attached to the lacrimal bones(75.1%).The obstructions were generally located around the entrance of the nasolacrimal duct(NLD).However,some were placed higher,with 7.63%blocked not lower than the OMT.There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction(r=-0.35,P<0.01).CONCLUSION:In this study,the OMT and MB-LB can be served as the landmarks in EN-DCR.Partial uncinectomy should be performed in most cases.The obstructions were generally located around the entrance of the NLD,but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery.
