在内镜达克里奥西斯托里诺斯托米术后,在局部鼻内类固醇覆盖下,骨颗粒瘤的回归过程
Shang-Te Ma1,2, Seonae Shin2, Apurva Navale2
1Department of Ophthalmology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
Scientific reports
|July 24, 2024
概括
鼻内类固醇在内镜达克里奥西斯托里诺斯托米 (DCR) 后有效治疗骨颗粒瘤,在95.8%的病例中,在7个月内完全回归. 这种方法避免了手术干预,并保持了患者的满意度.
科学领域:
- 眼科医生 眼科 眼科
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术病理学手术病理学
背景情况:
- 骨颗粒瘤是内镜达克里奥西斯托里诺斯托米 (DCR) 后的一个常见并发症.
- 这些颗粒瘤可能会阻碍DCR手术的功能成功.
- 骨颗粒瘤的管理选择历来包括手术干预,这可能导致并发症.
研究的目的:
- 调查鼻内类固醇在初级内 DCR 后促进骨颗粒瘤回归方面的疗效.
- 评估内类固醇治疗对DCR手术成功率的影响.
- 为了确定内鼻类固醇使用的最佳持续时间,以实现颗粒瘤的分离.
主要方法:
- 对57名患者 (72名骨) 的回顾性审查,这些患者在内镜后的DCR (2011-2015年) 开发了骨颗粒瘤.
- 所有患者从术后第一天开始接受局部鼻内类固醇喷雾.
- 额外的内注射triamcinolone乙化物注射用于广泛的颗粒瘤.
主要成果:
- 在接受治疗的骨中,69 (95.8%) 的骨颗粒瘤完全回归.
- 颗粒瘤完全消失的平均时间为6.9 ± 2.8个月.
- DCR的解剖学和功能性成功率分别为90.3%和84.7%,局部和内伤类固醇使用之间没有显著差异 (p=0.445).
结论:
- 持续使用鼻内类固醇是一种有效的非手术方法,用于在内镜DCR后解决骨颗粒瘤.
- 颗粒瘤回归通常发生在持续的鼻内类固醇应用后的6个月内.
- 这种保守的管理策略避免了需要鼻内外科手术的需要,减少了粘膜痕,提高了患者的满意度.
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