title: [Rosenmüller valve during endoscopic dacryocystorhinostomy in treating refractory nasolacrimal duct obstruction].
abstract: OBJECTIVE
  The objective of this study was to assess the efficacy of exposing Rosenmüller valve during endonasal endoscopic dacryocystorhinostomy (EES-DCR) in treating refractory nasolacrimal duct obstruction.
  
  
  METHODS
  Thirty six patients (47 eyes) with refractory nasolacrimal duct obstruction were entered into this study, including 13 patients (15 eyes) underwent nasal lacrimal duct intubation before, 18 patients (26 eyes) with small lacrimal sac, 2 patients underwent DCR before, 1 patient with functional nasal lacrimal duct obstruction, 1 patient with lacrimal mucocele, 1 patient with nasal trauma. During the DCR, the bone window was enlarged as wide as possible and the valve of Rosenmüller was exposed. The intubation of the lacrimal apparatus was performed if the lacrimal sac was very small and the Rosenmüller valve was tight. Functional endoscopic sinus surgery and septoplasty were performed simultaneously if necessary. Postoperatively, each patient was assessed by the symptom and nasal endoscopy.
  
  
  RESULTS
  The postoperative follow-up period ranged from 3 to 36 months. Thirty two patients(89.4%, 42/47 eyes) were cured, which presented as the disappearance of symptoms, the patency of the lacrimal ostium and the lacrimal duct irrigation was clear. One patient (2.1%, 1/47 eyes) was improved, which presented as the improvement of symptoms, a few hypertrophic scar around the lacrimal ostium and the lacrimal duct irrigation was clear. Four cases failed (8.5%, 4/47), which presented as symptomatic and obstruction of the lacrimal ostium. The total effective rate reached to 91.5%. No serious postoperative complications were found in all cases.
  
  
  CONCLUSIONS
  To expose Rosenmüller valve during endoscopic DCR in treating patients with refractory nasolacrimal duct obstruction could obviously increase the operative success rate, fewer complications, with no facial surgical scar. It is an ideal way to treat the refractory nasolacrimal duct obstruction.
authors.affiliation: Department of Otorhinolaryngology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: M
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Otorhinolaryngology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: S Q
authors.initials: SQ
authors.lastname: Wang
authors.affiliation: Department of Otorhinolaryngology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: M W
authors.initials: MW
authors.lastname: Li
authors.affiliation: Department of Otorhinolaryngology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Xing
authors.affiliation: Department of Otorhinolaryngology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: X P
authors.initials: XP
authors.lastname: Yuan
authors.affiliation: Department of Otorhinolaryngology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Otorhinolaryngology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: C L
authors.initials: CL
authors.lastname: Geng
mesh_terms: D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation; D007767:Lacrimal Duct Obstruction / Q000209:etiology / Q000628:therapy*; D009301:Nasolacrimal Duct / Q000601:surgery*; D011183:Postoperative Complications; D013997:Time Factors