코경유 눈물주머니코안연결술시 코패킹 물질로 사용한 NasoporeⓇ의 임상적 결과
Clinical Results of Nasopore® Nasal Packing on Endonasal Dacryocystorhinostomy
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목적: 코경유 눈물주머니코안연결술 후 코패킹 물질로 NasoporeⓇ 사용 시 수술 성공률과 수술 후 합병증 발생률을 알아보고자 하였다. 대상과 방법: 본원에서 일차 코눈물관폐쇄로 코경유 눈물주머니코안연결술을 시행받은 환자 558명 (699안) 을 NasoporeⓇ를 넣은 군(472안) 과 MerocelⓇ을 넣은 군 (227안) 으로 나누어 각 군별 수술 성공률, 비강내 유착, 육아종 형성, 골공 주위 점막의 상피화, 수술후 출혈 및 감염, 재수술 여부를 비교 분석하였다. 결과: 수술 성공률은 수술 후 1, 3개월째 NasoporeⓇ군이 99.1%, 98.6%로 MerocelⓇ군 97.2%, 95.1%에 비해 통계학적으로 유의하게높았으나, 술 후 1주, 6달에 유의한 차이는 없었다. 수술 2개월 이후까지 골공 주위 점막의 상피화가 지연되는 경우는 NasoporeⓇ군0%로 MerocelⓇ군 2.3%보다 통계학적으로 유의하게 낮았으나 그 외 수술 합병증에는 유의한 차이를 보이지 않았다. 결론: 코경유 눈물주머니코안연결술시 코패킹 물질로 NasoporeⓇ를 사용 시 MerocelⓇ보다 술 후 골공 주위 점막의 상피화 지연이적게 관찰되었고, 수술 후 초기 성공률 향상을 보였다.
Abstract
Purpose: To investigate the effects of Nasopore® as a nasal packing material on the surgical success rate and prevalence of postoperative complications after endonasal dacryocystorhinostomy (DCR). Methods: The present study included a total of 558 patients (699 eyes) with primary acquired nasolacrimal duct obstruction who underwent endonasal DCR; 227 eyes were packed with Nasopore® and 472 eyes were packed with Merocel®. The surgical success rate and postoperative complications such as synechiae, granulation, wound healing (osteal mucosal epithelium epithelialization), postoperative bleeding, infection, and revision rate were compared between the packing materials. Results: The surgical success rate of the Nasopore® group (99.1%, 98.6%) showed significantly better results than the Merocel®group (97.2%, 95.1%) at postoperative 1 and 3 months (p = 0.04, 0.03 Pearson chi-square test), whereas there was no statistically significant difference between the 2 groups in postoperative surgical success rate at 1 week and 6 months. In comparison of postoperative complications, the Nasopore® group (0%) showed a lower incidence of delayed wound healing (delayed epithelialization of osteal mucosal epithelium) than the Merocel® group (2.3%; p = 0.013), whereas there was no difference in granulation, synechiae, postoperative bleeding, infection and revision rate (p > 0.05). Conclusions: The Nasopore® group showed a lower proportion of delayed wound healing and improvement of the surgical success rate at an early postoperative period after endonasal DCR compared to non-absorbable nasal packing material.
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