| Purpose: Establish animal model of rabbits with experimentally inducedobstruction of lacrimal passage, to observe the changes of the pathological manifestations,mucosa-associated lymphoid tissue(MALT) and cavernous body on the development ofinflammation of lacrimal passage, and then discuss correlation about clinical course andpathological changes of the inflammation of lacrimal passage.Methods: Dacryocystitis was induced by injection of component through punctum into thenasolacrimal duct, and component was made by means of mixing MMA and PMMA byweight ratio2:1. The rabbit were divided into A, B, C, D, E, F five groups, adoptedcompletely random design. Group A: normal group; Group B:1week group; Group C:2weeks group; GroupD:4weeks group; Group E:8weeks group; Group F:16weeks group;Each groups were assessed irrigation test, lacrimal passage endoscopy examination,clinical manifestations and pathological examination. To examine the changing quantity ofMALT and the results statistically analyzed.Results: Experimental group appears the clinical manifestations of lacrimal sacinflammation after a week of lacrimal passage obstruction. Success rate of animal modelwere7/10of group B,8/10of group C,8/10of group D,9/10of group E,9/10of group F. Group A: Rabbits no the symptom of epiphora; Application of lacrimal passage endoscopy,we can find the mucosa of lacrimal sac is smooth, pale pink. Pathological manifestationswere normal. The Clinical manifestations of group B group C and group D showedconjunctival congestion epiphora follicle purulent secretion, and the trend of Clinicalmanifestations aggravate gradually among groups; With the lacrimal passage endoscopy,the manifestations of lacrimal sac showed mucosal hyperemia and hemorrhagic spot.Pathological manifestations showed epithelial cell swelling, necrosis and degree ofinflammatory cells infiltration. Except the above manifestations, we can also found mucosapresent pallor and proliferative sclerotic formation in the group D, with the lacrimalpassage endoscopy; Corresponding manifestations of pathology showed epithelial cellswelling, proliferation, and proliferative polypoid and collagen fibers forms of chronicin àammation. Group E and group F share the same clinical manifestations, such as mildconjunctival congestion epiphora and pressing lacrimal sac, the purulent secretion flowedfrom lacrimal punctum. The manifestations of group E and group F were different underlacrimal passage endoscopy, so were the pathological manifestations. Group E: with thelacrimal passage endoscopy, the manifestations of lacrimal sac showed mucosal pallor andproliferative sclerotic formation. Pathological manifestations showed proliferative polypoidforms of chronic in à ammation and epithelial necrosis è fibrous tissue proliferation. Group F:with the lacrimal passage endoscopy, the manifestations of lacrimal sac showed mucosalpallor and proliferative sclerotic and white membrane forms of chronic in àammation.Pathological manifestations showed epithelial necrosis, squamous metaplasia andsubepithelial brosis.The changes in the numbers of organized lymphoid tissue presented dynamically during thedevelopment of inflammation. From group A to group C, it presents a gradually increasedtrend, but from group D to group F, it presents a decrease gradually trend. There were nosignificant differences among groups in the number of organized lymphoid tissue oflacrimal sac, however for nasolacrimal duct we found opposite results. From group A to group D, the blood vessels of cavernous body have no change. But the blood vessels ofcavernous body presented a decrease gradually trend from group E to group F.Conclusion:1. Animal model of rabbits can be successfully established byobstruction of lacrimal passage with synthetic resin.2. Pathological manifestations different in the different dacryocystitis period of rabbits.According to pathological manifestation, the inflammation of lacrimal passage is dividedinto three stage: acute inflammatory period chronic inflammatory period and proliferativeperiod. This stage can be used as a reference of clinical diagnosis and treatment.3. Lacrimal passage endoscopy can make accurate judgment to mucosal changes of lacrimalsac during the inflammatory period of lacrimal passage, and the changes are consistent withthe pathological manifestations. It can be provided clinical guidance for the individualizedtreatment of lacrimal duct obstructive diseases.4. From chronic inflammation to scarred inflammation of lacrimal passage, visible was areduction up to a total loss of the cavernous body. It might play an important role in thepathogenesis of obstructive lacrimal duct disease.5. MALT is a normal constituent of the lacrimal passage. The quantity of MALT increasedgradually during acute inflammatory period and presented a declining trend during chronicinflammatory period, it involve in the inflammatory mechanisms of lacrimal passage.Remain to be further researched. |
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