Comparison Of The Effect Of There Different Surgical Approachs On Chronic Dacryocystitis And Nasolacrimal Duct Obstruction

[Objective] To investigate the difference of clinical effectiveness among dacryocystorhinostomy, dilatation of the nasolacrimal duct and permanent artificial nasolacrimal duct stent implantation for the treatment of chronic dacryocystitis and nasolacrimal duct obstruction.[Methods]149cases(168eyes) of chronic dacryocystitis were randomly divided into there groups. Group A(48cases,53eyes) was treated with dacryocystorhinostomy, group B(50cases,56eyes) was treated with dilatation of the nasolacrimal duct, group C(51cases,59eyes) was treated with permanent artificial nasolacrimal duct stent implantation. All groups used the same drugs before and after the operations. After the removal of indwelling catheter for group A, and from the first postoperative day on for group B and C, we began to syringe the lacrimal regularly and to give local treatment of anti-inflammatory as well as promoting nasal mucosa shrinking. Follow-up for4months was performed to observe the situation of lacrimal duct, epiphora and complication. Analyze therapeutic effects and the reasons of complication in the first and the fourth month after the operations.[Results] The first month postoperatively,for group A:the cure rate is92.45%,the effective rate is98.11%;for group B:the cure rate is76.79%, the effective rate is94.64%; for group C:the cure rate is93.10%, the effective rate is100%. Comparing the effectiveness of three groups, difference is statistically significant (P<0.05). No statistically significant effect was observed between group A and group C(P>0.05), both of them have better effectiveness than group B(P<0.05).The fourth months postoperatively, for group A:the cure rate is86.54%,the effective rate is96.15%;for group B:the cure rate is68.51%, the effective rate is88.89%;for group C:the cure rate is89.09%, the effective rate is98.18%. Comparing the effectiveness of three groups, difference is statistically significant (P<0.05). No statistically significant effect was observed between group A and group C (P>0.05), the cure rates of group A and group C are more higher than group B (P<0.05).[Conclusion] The implantation of artificial nasolacrimal duct stent and dacryocystorhinostomy have the same significant effect. Both of them have better effectiveness than dilatation of the nasolacrimal duct.