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Laryngorhinootologie 2007; 86(8): 597-610
DOI: 10.1055/s-2007-966734
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© Georg Thieme Verlag KG Stuttgart · New York

Diagnostik und Therapie von chronischer Epiphora und rezidivierender Dakryozystitis

Diagnosis and Treatment of Chronic Epiphora and Recurrent DacryocystitisM.  Bernal-Sprekelsen1 , I.  Alobid1 , J.-M.  Guilemany1 , M.  Tomás-Barberán2
  • 1HNO-Univ.-Klinik, Barcelona
  • 2HNO-Klinik, Hospital Son Dureta, Palma de Mallorca
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Publication History

Publication Date:
31 July 2007 (online)

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Zusammenfassung

Ziel des Artikels ist es, die klinisch relevanten diagnostischen Methoden des chronischen Tränenträufelns und der rezidivierenden Tränensackentzündungen zu erläutern, um unnötige Untersuchungen zu vermeiden. Hierbei wird besonders die Sondierung der proximalen Tränenwege zur Differenzialdiagnose des chronischen Tränenträufelns hervorgehoben. Des Weiteren werden Schritte zur chirurgischen Technik dargestellt, wie die des basal gestielten Lappens auf dem Agger nasi, der am Ende des Eingriffes zurückverlagert wird und eine beschleunigte Reepithelisierung der lateralen Nasenwand ermöglicht. Es werden potenzielle Komplikationen aufgezählt sowie Maßnahmen zu deren Vorbeugung und Behandlung. Langfristige Ergebnisse der endoskopischen Tränenwegsoperationen liegen in 750 Fällen, sowohl bei Erwachsenen als auch bei Kleinkindern, bei über 90 %iger Permeabilität und bestätigen diesen Zugang.

Abstract

The goal of this article is to highlight relevant diagnostic tools to assess chronic epiphora and recurrent dacryocystitis in order to avoid unnecessary diagnostic explorations. Probing of the canaliculi is important for the differential diagnosis of chronic epiphora. Surgical steps are detailed, such as the inferiorly based mucosal flap on the Agger nasi, which is repositioned at the end of the surgery improving wound healing on the lateral wall. Potential complications are presented, as well as measures to avoid and to treat them. Long-term follow-up of 750 endoscopic DCR confirms the good results in more than 90 % after endoscopic dacryocystorhinostomies in adults and in children.

Schlüsselwörter

endoskopische Tränenwegschirurgie - Tränensack - Epiphora - Dakryozystitis

Key words

endoscopic DCR - lacrimal sac - epiphora - dacryocystitis

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Prof. Dr. med. Manuel Bernal-Sprekelsen

Hospital Clinic

Servicio de ORL

Villarroel, 170, Esc. 8, 2A

08036 Barcelona

Email: mbernal@clinic.ub.es