Abstract
Objectives
The objectives of this study were to report a series of paediatric patients who underwent endoscopic endonasal dacryocystorhinostomy (DCR) for primary congenital nasolacrimal duct obstruction (NLDO).
Methods
This is a retrospective, noncomparative review of all consecutive cases in two lacrimal clinics between January 1999 and October 2004. The main outcome measures were patients’ demographics, previous treatments, clinical presentation, operative and postoperative complications, postoperative follow-up and resolution of epiphora.
Results
Twenty-one patients (15 males) with a mean age of 6±3.5 years (range, 2–14 years) underwent 26 endoscopic DCR operations for congenital NLDO. Sixteen cases were unilateral, and five were bilateral. In 13 cases (50.0%), there was a history of epiphora and chronic dacryocystitis with or without a mucocele. Two cases (7.7%) presented with acute dacryocystitis, and 11 (42.3%) had only a history of epiphora. Previous procedures included probing and irrigation in 25 cases (96.2%) and insertion of Crawford tubes in 19 cases 973.1%). During a mean postoperative follow-up period of 18±8 months, the anatomical success rate (free flow of fluorescein sodium and patency of ostium on nasal endoscopy) was 100%, and the clinical success rate (resolution of epiphora) was 92.3%.
Conclusion
Endoscopic endonasal DCR is an effective treatment modality for congenital NLDO that compares favourably with the reported success rates of external DCR.
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References
Barnes EA, Abou-Rayyah Y, Rose GE (2001) Pediatric dacryocystorhinostomy for nasolacrimal duct obstruction. Ophthalmol 108:1562–1564
Berlucchi M, Staurenghi G, Brunori PR, Tomenzoli D, Nicolai P (2003) Transnasal endoscopic dacryocystorhinostomy for the treatment of lacrimal pathway stenoses in pediatric patients. Int J Pediat Otolaryngol 67:1069–1074
Cunningham MJ, Woog JJ (1998) Endonasal endoscopic dacryocystorhinostomy in children. Arch Otol Head Neck Surg 124:328–333
Guerry D 3rd, Kendig EL Jr (1948) Congenital impatency of the nasolacrimal duct. Arch Ophthalmol 39:193–204
Hakin KN, Sullivan TJ, Sharma A, Welham RA (1994) Paediatric dacryocystorhinostomy. Aust N Z J Ophthalmol 22:231–235
Katowitz JA, Welsh MG (1987) Timing of initial probing and irrigation in congenital nasolacrimal duct obstruction. Ophthalmology 94:698–705
Kominek P, Cervenka S (2005) Pediatric endonasal dacryocystorhinostomy: a report of 34 cases. Laryngoscope 115:1800–1803
MacEwen CJ, Young JD (1991) Epiphora during the first year of life. Eye 5:596–600
Nowinski TS, Flanagan JC, Mauriello J (1985) Pediatric dacryocystorhinostomy. Arch Ophthalmol 103:1226–1228
Paul TO, Shepherd R (1994) Congenital nasolacrimal duct obstruction: natural history and the timing of optimal intervention. J Pediatr Ophthalmol Strabismus 31:362–367
Petersen RA, Robb RM (1978) The natural course of congenital obstruction of the nasolacrimal duct. J Pediatr Ophthalmol Strabismus 15:246–250
Robb RM (1998) Success rates of nasolacrimal duct probing at time intervals after 1 year of age. Ophthalmology 105:1307–1310
Tsirbas A, Davis G, Wormald PJ (2004) Mechanical endonasal dacryocystorhinostomy versus external dacryocystorhinostomy. Ophthal Plast Reconstr Surg 20:50–56
Tsirbas A, Wormald PJ (2002) Endonasal dacryocystorhinostomy with mucosal flaps. Am J Ophthalmol 135:76–83
VanderVeen DK, Jones DT, Tan H, Petersen RA (2001) Endoscopic dacryocystorhinostomy in children. JAAPOS 5:143–147
Watkins LM, Janfaza P, Rubin PA (2003) The evolution of endonasal dacryocystorfhinostomy. Surv Ophthalmol 48:73–84
Welham RA, Hughes SM (1985). Lacrimal surgery in children. Am J Ophthalmol 99:27–34
Woog JJ, Kennedy RH, Custer PL, MD, Kaltreider SA, Meyer DR, Camara JG (2001) Endonasal dacryocystorhinostomy. A report by the American academy of ophthalmology. Ophthalmology 108:2369–2377
Wormald PJ (2002) Powered endoscopic dacryocystorhinostomy. Laryngoscope 112:69–72
Young JD, MacEwen CJ, Ogston SA (1996) Congenital nasolacrimal obstruction in the second year of life: a multicenter trial of management. Eye 10:485–491
Yung MW, Hardman-Lea S (2002) Analysis of the results of surgical endoscopic dacryocystorhinostomy: effect of the level of obstruction. Br J Ophthalmol 86:792–794
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Leibovitch, I., Selva, D., Tsirbas, A. et al. Paediatric endoscopic endonasal dacryocystorhinostomy in congenital nasolacrimal duct obstruction. Graefe's Arch Clin Exp Ophthalmo 244, 1250–1254 (2006). https://doi.org/10.1007/s00417-006-0273-y
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DOI: https://doi.org/10.1007/s00417-006-0273-y