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
