Wydanie 4/2012
str. 48

Endoskopowa marsupializacja jako alternatywna metoda leczenia wrodzonej torbieli worka łzowego u niemowląt

Endoscopic Marsupialization as an Alternative Method of Congenital Dacryocystocele Treatment in Infants

Agnieszka Moll1, Violetta Piotrowska2, Małgorzata Budzińska-Mikurenda1, Anna Zakrzewska2, Anna Niwald1

1 Klinika Okulistyki Dziecięcej Katedry Pediatrii Zabiegowej Uniwersytetu Medycznego w Łodzi Samodzielnego Publicznego Zakładu Opieki Zdrowotnej Uniwersyteckiego Szpitala Klinicznego Nr 4 Uniwersytetu Medycznego w Łodzi
Kierownik: dr hab. n. med. Anna Niwald
2 Klinika Otolaryngologii, Audiologii i Foniatrii Dziecięcej Katedry Pediatrii Zabiegowej Uniwersytetu Medycznego w Łodzi Samodzielnego Publicznego Zakładu Opieki Zdrowotnej Uniwersyteckiego Szpitala Klinicznego Nr 4 Uniwersytetu Medycznego w Łodzi
Kierownik: dr hab. n. med. Anna Zakrzewska, profesor UM


Summary: Dacryocystocele is an infrequent congenital nasolacrimal drainage anomaly. Probing and irrigation of nasolacrimal system is successful in some patients. Several authors recommend probing with extensive marsupialization of the cyst to prevent recurrence when probing alone is insufficient. This method allows to restore anatomic pathway for tears outflow.
Purpose: The aim of the study was to evaluate the efficacy of endoscopic intranasal marsupialization in children with congenital dacryocystocele after unsuccessful probing.
Material and Methods: The study group consisted of 7 children with one-sided dacryocystocele, 4 females and 3 males, with typical clinical manifestations of medial canthal mass, excessive tearing and conjunctivitis. Ultrasound examination was performed in all patients, computed tomography in 4. Dilation of the lacrimal sac, nasolacrimal duct with surrounding bone expansion and intranasal cyst were found. Standard treatment with topical antibiotics, massage and probing was performed in all 7 children. In 4 patients this method was unsuccessful. Marsupialization in general anesthesia using endoscope and clamps for excision of wide opening in intranasal cystocele with simultaneous probing of lacrimal system was taken in that group.
Results: In all 4 patients with congenital dacryocystocele procedure of marsupialization was performed successfully. No complications nor side effects of this method were observed. During follow-up which lasted for at least 12 months no symptoms recurrence was found.
Conclusions: Endoscopic intranasal marsupialization is successful method of nasolacrimal system patency restoration in children with congenital dacryocystocele, alternative to dacryocystorhinostomy.

Słowa kluczowe: wrodzona torbiel worka łzowego, niedrożność dróg łzowych, marsupializacja.

Keywords: congenital dacryocystocele, lacrimal duct obstruction, marsupialization.


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