Application Of Nasopore For Endoscopic Trasnasal Dacryocystorhinostomy

Objective: The goals of this study were to evaluate the results of Endoscopic trasnasal Dacryocystorhinostomy(Et-DCR)with Nasopore which is used for intubating and supporting the lacrimal ostium.Material and Methods: We collecte 80(81 eyes)patients who underwent Et-DCR for chronic dacryocysticis at the Hebei Medical University Second Hospital from August 2015 through August 2016.All patients underwent a comprehensive ophthalmic examination,irrigation of the nasolacrimal drainage system,and intranasal examination.80 patients with 81 eyes are randomly assigned to group A and group B.In group A,Nasopore is intubated in the lacrimal ostium and covered on the conjunction of mucosa flaps or the exposed bone.In group B,Nasopore is only covered on the conjunction of mucosa flaps or the exposed bone,but not intubated in the lacrimal ostium.In group A,there is 42 female(43 eyes)and 8 male(8 eyes),29 right eyes,22 left eyes,the mean age is 51.04±2.04 years old,the mean disease course is 7.22±0.53 years,the mean size of the lacrimal sac is 0.51±0.03cm3.In group B,there is 24 female(24 eyes)and 6 male(6 eyes),18 right eyes,12 left eyes,the mean age is 46.67±2.79 years old,the mean disease course is 5.87±0.59 years,the mean size of the lacrimal sac is 0.52±0.05cm3.The size of the lacrimal sac is calculated by the product of horizontal diameter,sagittal diameter and vertical diameter which measured from the lacrimal sac radiography.Through statistics and analysis of gender,eyes,age,disease course and size of the lacrimal sac,observe whether there has significantly difference or not,the regular follow up was curried out 1 month,3 months and 6 months after surgery by the nasal endoscope.i Inquire patients in group A and group B whether they have symptoms of epiphora and pyorrhea;ii Treat with irrigation of lacrimal passage and observe whether the lacrimal passage is clear or not;iii Observe whether the ostium is open or not under the nasal endoscope.Regard these results as standards of evaluating the system reconstruction rates.Record the results of the system reconstruction rates and information about granuloma and/or scar formation 1 month,3 months and 6 months after operation respectively.Results: 80 cases(81 eyes)finish this trial with 51 eyes in group A and 30 eyes in group B.There has no significantly difference about gender,eyes,age,disease course and size of the lacrimal sac(P>0.05)between group A and group B.The status of wound is examined under the nasal endoscope 2weeks,1 month,3 months and 6 months after operation respectively.1 comparion of the system reconstruction rates between group A and group BThe successful rate of lacrimal system reconstruction is 100.0%(51/51)1 months after surgery in group A and 83.3%(25/30)in group B,and significant statistical difference is found between two groups(?2=6.410 P=0.011).The successful rate of lacrimal system reconstruction is 98.0%(50/51)3 months after surgery in group A and 76.7%(23/30)in group B,and significant statistical difference is found between two groups(?2=7.441 P=0.006).The successful rate of lacrimal system reconstruction is 96.1%(49/51)6 months after surgery in group A and 70.0%(21/30)in group B,and significant statistical difference is found between two groups(?2=8.837 P=0.003).2 comparion of the results about granuloma and/or scar formation between group A and group B1 months after surgery,the ostiums of 2 eyes in group A produce granuloma,but not influence the open ostium.However,the ostiums of 5 eyes in group B produce granuloma and lead to closure of the ostium.3 months after surgery,the ostium of 1 eye in group A produce granuloma,and lead to closure of the ostium.The ostiums of 7 eyes in total in group B produce granuloma and lead to closure of the ostium.6 months after surgery,the ostiums of 4 eyes in total in group A produce granuloma,and 2 of them lead to closure of the ostiums,and 2 of them not influence the open ostiums.The ostiums of 9 eyes in total in group B produce granuloma and lead to closure of the ostium.4 ostiums of 4 eyes in total in group A produce granuloma and/or scar(4/51,7.8%),and 9 ostiums of 9 eyes in total in group B produce granuloma and/or scar(9/30,30.0%),and it has significant statistical difference between two groups(?2=5.336,P=0.021).Conclusions: Nasopore can support the ostium effectively applied for Endoscopic trasnasal Dacryocystorhinostomy,and prevent granuloma and scar formation,therefore it keeps the ostium open and increases successful rate effectively.Application of Nasopore for Endoscopic trasnasal Dacryocystorhinostomy is worth promoting clinically.