Ulus Travma Acil Cerrahi Derg. 2017; 23(1): 66-71 | DOI: 10.5505/tjtes.2016.65021

Travmatik kanalikül kesi tamiri yapýlan hastalarda anatomik ve fonksiyonel baþarýnýn deðerlendirilmesi

Hasan Aytoðan¹, Þeyda Karadeniz Uðurlu^2
1Tepecik Eðitim Ve Araþtýrma Hastanesi, Göz Hastalýklarý Kliniði, Ýzmir
²Katip Çelebi Üniversitesi Týp Fakültesi, Göz Hastalýklarý Anabildim Dalý, Ýzmir

AMAÇ: Tek taraflý kanaliküler kesi tamiri uygulanan hastalarda anatomik ve fonksiyonel baþarýyý deðerlendirmek.
GEREÇ VE YÖNTEM: 1 Ocak 2009 ile 31 Aralýk 2014 tarihleri arasýnda tek cerrah tarafýndan kanalikül kesi tamiri yapýlan hastalar çalýþmaya dahil edildi. Hastalarýn demografik verileri, travmanýn zamaný ve etkeni, uygulanan cerrahi yöntem ve izlem süreleri kaydedildi. Hastalarýn sulanma yakýnmalarý cerrahi sonrasý entübasyon tüpünün çýkarýlmasýný takiben en son kontrol muayenede Munk skorlamasýna göre deðerlendirildi. Gözyaþý yolunun açýklýðý kanaliküler irigasyon ile incelendi.
BULGULAR: Tek taraflý kanaliküler kesi tamiri yapýlan 41 hastanýn (35 erkek, 6 kadýn) ortalama yaþý 31.85±18.9 (sýnýrlar, 1–79) idi. Travma daðýlýmý indirekt-avülsif yaralanma %66 (n=27), direkt-penetran yaralanma %34 (n=14) þeklindeydi. Kesi yeri sol alt kanalikül %63.4 (n=26), sað alt kanalikül %19.5 (n=8) sað üst kanalikül %9.8 (n=4) ve sol üst kanalikül %7.3 (n=3)olarak saptandý. Kýrk bir hastadan 10’una pigtai lprob ile bikanaliküler anüler entübasyon uygulanýrken, 31 hastaya monokanaliküler entübasyon uygulandý. Ýzlem süresi ortalama 6±5.7 ay idi. Hastalarýn tümünde lavaj açýk bulundu. Munk skoru hastalarýn tamamýnda grade 0 olarak belirlendi.
TARTIÞMA: Günümüzde mikrocerrahi yöntemlerle yapýlan kanalikül kesi tamiri ile çok baþarýlý sonuçlar elde edilmektedir.

Anahtar Kelimeler: Epifora, göz yaþý menisküsü, travmatik kanlikül kesisi.

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Evaluation of anatomical and functional outcomes in patients undergoing repair of traumatic canalicular laceration

Hasan Aytoðan¹, Þeyda Karadeniz Uðurlu^2
1Department Of Eye Disease, Tepecik Training And Research Hospital, Izmir, Turkey
²Department Of Eye Disease, Katip Celebi University Medicine Faculty, Izmir, Turkey

BACKGROUND: The present study was designed to evaluate functional and anatomical success of traumatic canalicular laceration repair.
METHODS: Consecutive patients who presented at Atatürk Training and Research Hospital Eye Clinic, Ýzmir Katip Çelebi University Faculty of Medicine and had canalicular laceration repair performed by the same surgeon between January 2009 and December 2014 were included in the study. Demographic data, length of time between injury and surgery, and cause of the trauma, surgical method employed, and duration of follow-up were recorded. Postoperative epiphora was evaluated using Munk score. Patency of lacrimal system was assessed with canalicular irrigation.
RESULTS: Thirty-five male and 6 female patients were included in the study. Mean age of 41 participants was 31.85±18.9 years (range: 1–79 years). Avulsive injury was observed in 66% (n=27), and direct (penetrating) injury in 34% (n=14). Distribution of injured canaliculi was as follows: left inferior canaliculus 63.4% (n=26), right inferior canaliculus 19.5% (n=8), right superior canaliculus 9.8% (n=4), and left superior canaliculus 7.3% (n=3). Thirty-four patients had monocanalicular tube implantation (mini-Monoka) and 10 patients had bicanalicular annular intubation using pigtail probe. Average follow-up time was 6±5.7 months. Munk score was Grade 0 in all patients. Canalicular irrigation indicated all canaliculi were patent.
CONCLUSION: Recent microsurgical techniques result in successful repair of canalicular laceration.

Keywords: Epiphora, tear meniscus, traumatic canalicular injury.

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