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世界核心医学期刊文摘（眼科学分册） 2005年第3期1卷 24-24页

作者： baldeschi l. MacAndie K. Hintschich C.R. 秦雪娇

To compare the extent of mucosal.margins remaining unsutured at the end of ext ernal.dacryocystorhinostomy (DCR) using singl. or doubl. fl.p techniques and to eval.ate the infl.ence on outcome. Prospective, consecutive case series. The num ber and l.ngth of mucosal.margins remaining unsutured at the end of external.DCR were eval.ated in 64 patients. Mucosal.anastomosis was performed using either a conservative (group 1) or extended (group 2) doubl. fl.p, or a singl. fl.p (gro up 3) dissection. Patients were sel.cted for group 1 if the regional.anatomy per mitted the desired dissection. Al. other patients were randomized to group 2 or 3. The mean l.ngth of unsutured mucosal.margins was cal.ul.ted for each group. S ubjects were fol.owed up to 12 months, with final.success rate recorded. In grou ps 1, 2, and 3 respectivel.: 11, 24 and 29 patients were recruited; four, 12, an d 10 mucosal.margins remained unsutured; and the mean l.ngth of unsutured mucosa l.margins was 16.36 mm (SD=2.8), 70.66 mm (SD=9.3), and 62.00 mm (SD=6.0). The m ean l.ngth of unsutured mucosal.margins was significantl. different, al.hough gr oups 1 and 2 col.ectivel. did not have a significantl. different mean l.ngth of unsutured mucosal.margin from group 3. Mean fol.ow up was 11 months (SD=2.2), 6 3 patients (98.43%) had a successful.outcome with no significant difference amo ng groups (P=.429). Different patterns of mucosal.dissection in external.DCR cre ate a different number and extent of unsutured mucosal.margins which do not appe ar to adversel. affect the success rate of external.DCR.

关键词：泪囊鼻腔造瘘术切除法局部解剖结构病例研究无显著性差异有显著性差异

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眼眶减压术中深部眶外侧壁的祛除:有益于眼球突出复位及其对持续性复视的影响

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世界核心医学期刊文摘(眼科学分册) 2006年第2期 17-18页

作者： baldeschi l.MacAndie K Hintschich C. 桑延智 Department o f Ophthal.ol.gy Academic Medical Center University of Amsterdam Meiber-gdreef 91105 AZ Amsterdam Netherlands Dr.

PURPOSE: To eval.ate the contribution of maximal.removal.of the deep l.teral.wal. of the orbit to exophthal.os reduction in Graves orbitopathy and its infl.ence on the onset of consecutive dipl.pia. DESIGN: Case-control.study. METHODS: The medical.records of two cohorts of patients affected by Graves orbitopathy with exophthal.os l.pia, were retrieved at random from the pool.of patients decompressed for rehabil.tative reasons at our institution (01/1990 to 12/2003), and retrospectivel. reviewed. They had been treated with an extended (cases, group 1, n=15) or conservative (control., group 2, n=15) 3- wal. orbital.decompression performed through a coronal.approach. The deep portion of the l.teral.wal. had been removed in the extended decompression group whil. preserved in the conservative decompression group. Demographics, preoperative characteristics, and surgical.outcome were compared. The difference in mean exophthal.os reduction between groups 1 and 2was considered to be the contribution of the deep l.teral.wal. to reduction of exophthal.os. RESUl.S: Groups 1 and 2 were drawn from a pool.of 37 and 335 patients, respectivel.. Demographics and preoperative characteristics of the two groups were not significantl. different. The mean contribution of the deep l.teral.wal. to exophthal.os reduction was 2.3 mm. The onset of consecutive dipl.pia was not significantl. different between the two groups (case n=2/15, control. n=5/15; P = .203). Dipl.pia resol.ed spontaneousl. in al. the patients of group 1, whil. al. the patients of group 2 required surgery. CONCl.SIONS: Removal.of the deep l.teral.orbital.wal. as part of a coronal.approach, 3- wal. decompression, enhances the degree of exophthal.os reduction without increasing the risk of consecutive dipl.pia.

关键词：持续性复视深部外侧壁眼球突出

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