Clinical Study Of Surgical Treatment Of Nasal Endoscopic Lacrimal Related Diseases

Objective:Through retrospective analysis of patients with traumatic and benign neoplastic lacrimal system diseases treated under nasal endoscopy in our department,the symptoms and symptoms of patients with traumatic and benign neoplastic lacrimal system diseases before and after nasal endoscopic surgery were discussed.The improvement of the quality of life and the summary of clinical treatment experience provide a reference basis for the treatment of such complicated lacrimal system diseases under nasal endoscopy.Methods:Collected from September 2014 to September 2019,60 patients with traumatic lacrimal duct injury and 21 patients with lacrimal system disease caused by benign tumors of the nasal cavity and paranasal sinuses who were treated by Otolaryngology Head and Neck Surgery of Guizhou Provincial People’s Hospital and followed up for more than 6 months were collected.Research objects,among which traumatic patients were divided into less than one month group and more than one month group according to the course of the disease.The VAS score and Munk grading were performed for all patients before operation.All patients were treated by the same operator under nasal endoscopy,and the intraoperative conditions were recorded in detail.Postoperative regular anti-inflammatory,anti-swelling and dressing change treatments,regular outpatient follow-up visits to clean up nasal secretions and observe the recovery of nasal mucosa,and VAS scores and Munk grading were performed on patients in January,March,and June after surgery.Patients with tumors Add the Chinese version of the SNOT-22 scale to evaluate the improvement of patients ’symptoms and quality of life.The SPSS 26.0 statistical software was used to statistically analyze the preoperative and postoperative curative effect and the improvement of the quality of life of the patients Results:1.The two groups of patients with traumatic lacrimal system injury had no significant difference in VAS scores before surgery(P>0.05).The VAS scores of patients with a course of more than 1 month after 1 month and 3 months after surgery were significantly higher than those with less than the course of disease.There was no significant difference in VAS scores between the two groups of patients at 1 month(P<0.05)and 6 months after surgery(P>0.05).The VAS scores of the two groups of patients with different course of disease decreased significantly with time(P<0.05).The Munk grading status of the two groups of patients was lower than that before the operation at 1 month,3 months,and 6 months after the operation,and the difference was statistically significant(P<0.05).The effective rate of treatment for patients with a course of less than one month was 93.3%,and the effective rate for patients with a course of more than one month was 66.7%.The effective rate of treatment for patients with a course of less than one month was significantly higher than that of patients with a course of more than one month.2.Accompany With the increase of time,the VAS scores of patients with benign neoplastic lacrimal system diseases decreased significantly,and the difference was statistically significant(P<0.05).The Munk grades of 1 month,3 months,and 6 months after surgery were compared with those before surgery.All were significantly reduced,and the difference was statistically significant(P<0.05).3.The scores of the Chinese version of the SNOT-22 scale before surgery in the tumor group were compared with the scores of 1 month,3months,and 6 months after surgery,and the differences were statistically significant(P<0.05).Conclusions:1.The treatment of traumatic lacrimal duct injury diseases under nasal endoscopy has the advantages of clear vision,no scars on the face,and less bleeding.Surgery can improve the patients’ symptoms and improve their quality of life.2.For patients with traumatic lacrimal system diseases with clear bone fragments incarceration and displacement of the lacrimal duct,early surgery to remove mechanical obstructive factors can reduce the risk of lacrimal duct scar stenosis in the later stage,which is beneficial to improve the efficacy of surgery.3.For patients with lacrimal system symptoms caused by benign tumors of the nasal cavity and paranasal sinuses,the lacrimal system symptoms have been significantly improved after nasal endoscopic surgery,and the quality of life of the patients has been improved compared to before the operation.