Silicone nasolacrimal intubation: our experience in long term cases

L. Bauchiero, F. Monteu, R. Orlassino, P. Tavormina, G. Vadalà
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Abstract

Purpose: To evaluate the bicanalicular tube structural integrity and the anatomical and functional post operative results of cases of long and very long bicanalicular intubation (from 2 to 13 years). Methods: We studied all the patients of our Department with long-lasting intubation (greater than one year), from 2000 to 2021. We obtained an histocytological evaluation of the material of intubation and a nasal endoscopy. We investigated the causes of the long permanency and the patient tolerability. Results: In our study, 6 eyes from 5 patients (4 women and 1 man) underwent a nasolacrimal duct intubation. The mean intubation permanency time was 6.8 years and the median value was 7 years (minimum 2 years, maximum 13 years). The bicanalicular tube examinations found traces of mucus made of amorphous protein material, sporadic leukocytes and histiocytes. In all the patients the nasal endoscopy showed good conditions of the middle meatus mucosa. Conclusions: In complex cases, such as multiple re-operations, inflamed and small lacrimal sac, fibrotic sac, inflamed nasal mucosa for previous nasal pathologies, a permanent silicone tube could be a reasonable choice as it appears to be well tolerated and without major complication risks.
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硅胶鼻泪插管:我们长期病例的经验
目的:评价长及超长双管插管(2 ~ 13年)患者双管结构完整性及术后解剖功能结果。方法:选取2000年至2021年我科所有长期插管(1年以上)患者为研究对象。我们对插管材料和鼻内窥镜进行了组织细胞学评估。我们调查了长期疗效和患者耐受性的原因。结果:在本研究中,5例患者(4女1男)6眼行鼻泪管插管。平均插管时间为6.8年,中位数为7年(最小2年,最大13年)。双管检查发现由无定形蛋白物质组成的粘液痕迹,零星的白细胞和组织细胞。所有患者的鼻内窥镜检查均显示中鼻道粘膜状况良好。结论:对于复杂的病例,如多次再手术,泪囊发炎和小,纤维化囊,鼻黏膜炎症既往鼻腔病变,永久硅胶管是一种合理的选择,因为它具有良好的耐受性和无重大并发症的风险。
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