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Pediatric nasolacrimal duct obstruction-benefit of a combined therapeutic approach

Abstract

Background

Pediatric nasolacrimal duct obstruction (PNDO) requires therapeutic intervention after conservative procedures failed. As resilient treatment guidelines for the treatment are missing, the aim of this study was to evaluate the advantages of two different intervention techniques in children with PNDO.

Methods

Between January, 2006 and June, 2014, 233 children (0-208 months) were treated either with conventional probing by ophthalmologists only (Group I) or with endonasal endoscopic interdisciplinary approach (Group II). The clinical outcome was analyzed.

Results

The overall success rate of Group I was 93.4% compared to 98.4% of Group II (P<0.05). 50% of all interventions (n=62) of Group II required further surgical procedures in addition to probing/irrigation, particularly with regard to children <6 and >24 months.

Conclusions

Endoscopic control in treatment of PNDO allows exact identification of the stenosis and appropriate surgical intervention with an improved clinical outcome. Endonasal endoscopic surgical techniques should be the standard PNDO treatment.

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Authors and Affiliations

Authors

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Correspondence to Miloš Fischer.

Additional information

Funding: None.

Ethical approval: The study was performed in accordance with the Declaration of Helsinki. Informed consent was obtained from all patients prior to surgery.

Competing interest: The authors have no conflicts of interest to declare.

Contributors: Fischer M and Mozet C ideated the study, analyzed the data, and wrote the paper. Horn IS and Pirlich M collected and analyzed the data, and revised the paper. Otto M and Dietz A revised the paper.

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Fischer, M., Horn, IS., Otto, M. et al. Pediatric nasolacrimal duct obstruction-benefit of a combined therapeutic approach. World J Pediatr 13, 427–432 (2017). https://doi.org/10.1007/s12519-017-0041-6

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  • DOI: https://doi.org/10.1007/s12519-017-0041-6

Key words

  • dacryocystocele
  • Hasner valve
  • nasal endoscopy
  • nasolacrimal duct probing
  • pediatric nasolacrimal duct obstruction