Suzno oko kao posljedica traumatskih ozljeda suznog aparata

master's thesis

• Title (english): Epiphora as a result of lacrimal drainage system injury
• Author: Karla Laškarin
• Mentor: Jelena Juri Mandić (mentor)
• Committee member: Tomislav Jukić (predsjednik povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Committee member: Jelena Juri Mandić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Suzno oko je stanje u kojem dolazi do prelijevanja suza preko ruba donjeg kapka zbog poremećaja odvodnje suza. Može nastati i u pacijenata sa prohodnim suznim sustavom, kada se to naziva funkcionalnom epiforom.
Suzno oko kao posljedica traumatske ozljede suznog aparata najčešće nastaje zbog laceracija suznih kanalića. Gotovo 70% ozljeda se odnosi na gornji dio odvodnog suznog sustava, dok preostalih 30% odlazi na ozljede donjeg dijela odvodnog suznog aparata. Evaluaciju ozljede treba započeti uzimanjem cjelovite i detaljne anamneze, kompletnim pregledom oka i nosne šupljine. Sondiranje i ispiranje suznih puteva te test nestajanja fluorescencijske boje (FDDT) pružaju uvid u prohodnost suznog sustava. Radiološke pretrage koje se provode su dakriocistografija (DCG), „multi slice“ kompjuterizirana tomografija (MSCT) i magnetska rezonanca (MR). Budući da ozljede suznog sustava često dolaze u sklopu trauma glave, liječenje nazolakrimalnih ozljeda treba odgoditi dok se stanje pacijenta ne stabilizira i on bude izvan životne opasnosti. Za rekonstrukciju laceriranih kanalića koriste se monokanalikularni silikonski stentovi kao što su Mini MONOKA i MASTERKA ili bikanalikularni stentovi BIKA po Crawford-u i Ritleng-u. Liječenje ozljeda donjeg dijela suznog sustava je izazovno zbog promijenjene koštane anatomije nazolakrimalnog sustava kao i često prisutnih postoperativnih ožiljaka i fibroze, a zlatni standard kirurškog liječenja je dakriocistorinostomija (DCR) po Totti-ju.

Abstract (english)

Epiphora is a condition in which the tears overflow over the edge of the lower eyelid due to impairment of drainage. This condition may also occur in patients with a patent lacrimal drainage system, which is called functional epiphora.
Epiphora as a result of lacrimal drainage system injury usually develops due to lacerations of lacrimal canaliculi. Almost 70% of injuries occur in the upper part of the drainage system, while the remaining 30% of injuries cause trauma to the lower part of the drainage system. One should begin the evaluation of injuries by taking detailed medical history, followed by thorough ocular and nasal examination. Diagnostic probing and irrigation and fluorescein dye disappearance test (FDDT) are performed to asses patency of the lacrimal drainage system. Imaging techniques that are used are dacryocystography (DCG), multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI). Being that lacrimal drainage system injuries are often accompanied with trauma to the head, treatment of nasolacrimal injuries should be delayed until the condition of the patient is stabilised. Monocalicular silicone stents such as Mini MONOKA and MASTERKA or bicanalicular BIKA Crawford and Ritleng stents are used to reconstruct lacerated canaliculi. Treatment of the lower part of the lacrimal drainage system is challenging because of the changed bone anatomy of the nasolacrimal system and the presence of postoperative scarring and fibrosis. The gold standard surgical procedure is Totti's dacrocystrinostomy (DCR).

• Keywords: suzno oko; dakriocistografija; dakriocistorinostomija; silikonski stentovi
• Keywords (english): epiphora; dacryocystography; dacryocystorhinostomy; silicone stents
• Language: croatian
• URN:NBN: urn:nbn:hr:105:609479
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-11-22 09:57:33