한국인에서의 눈물소관과 눈물주머니의 연결 형태
Frequency and Characteristic Findings of the Common Canaliculus in Koreans
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목적: 디지털 감산 눈물주머니조영술을 이용하여 한국인에서의 눈물소관과 눈물주머니의 해부학적 연결 형태를 알아보고자 한다. 대상과 방법: 2010년 1월부터 12월까지 눈물흘림을 주소로 내원하여 디지털 감산 눈물주머니조영술을 시행받은 248명(496안)을 대상으로 눈물소관의 연결형태를 조사하였다. 눈물소관과 눈물주머니의 연결은 type I: 공통눈물소관을 갖는 경우, type II: 눈물소관들이공통눈물소관을 이루지 않고 하나의 입구를 통해 눈물주머니로 들어가는 경우, type III: 위, 아래 눈물소관들이 독립적으로 두 개의입구를 갖는 경우로 분류하였다. 결과: 총 496안 중 type I은 90.5% (449/496안)이었으며, type II는 8.3% (41/496안), type III는 1.2% (6/496안)였다. 양안이 서로 다른형태의 눈물소관의 연결을 보이는 경우는 7.3% (18/248명)였다. 결론: 비록 소수의 경우이지만 공통눈물소관이 존재하지 않을 수 있으며, 눈물소관과 눈물주머니의 연결 형태가 양안이 다른 형태일수 있음을 주지하는 것은 눈물길 질환 환자를 치료, 접근하는 데 도움이 될 것이다.
Abstract
Purpose: To investigate the different types of anatomical connection between the lacrimal sac and the canaliculi using digital subtraction dacryocystography (DCG) in Koreans. Methods: The authors of the present study performed digital subtraction DCG in Korean patients who presented with epiphora from January 2010 until December 2010. The 248 patients (496 eyes) who achieved a satisfactory DCG image were classified as follows: 1) type I: visible common canaliculus (CC), 2) type II: no visible CC and the canaliculi entering the sac at the point where they meet on the sac wall (common opening), 3) type III: no visible CC and common opening, and each canaliculus entering the sac from different points. Results: Out of a total of 496 eyes, CC was observed in 449 eyes (type I: 90.5%). In 41 eyes (8.3%), the CC was absent (type II), but the upper and lower canaliculi joined at the wall of the lacrimal sac. In 6 eyes (1.2%), the upper and lower canaliculi entered the sac separately (type III). Eighteen patients (7.3%) showed different types of lacrimal drainage system between the 2 eyes. Conclusions: The CC may not exist in all patients, and the type of anatomical connection between the lacrimal sac and the canaliculi may be different between the eyes in the same individuals. Although such patients comprise a minority, anatomical knowledge of the lacrimal drainage system could be helpful to assess and manage patients with lacrimal drainage disorder.
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