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Results of endoscopic assisted probing for congenital nasolacrimal duct obstruction in older children.
Int J Pediatr Otorhinolaryngol. 2008 Jun; 72(6):891-6.IJ

Abstract

PURPOSE

To evaluate the results of lacrimal probing with the use of nasal endoscopy and identify the anatomical anomalies responsible for the symptoms in older children.

METHODS

Fifty-two eyes of 40 children with congenital nasolacrimal duct obstruction underwent primary probing of the lacrimal duct under general anaesthetic in conjunction with nasal endoscopy. Patients followed up for at least 6 months. Cure was defined as complete resolution of symptoms or minimal symptoms brought on by cold or wind.

RESULTS

The age range was 12-126 months. In 30/52 (57.7%) eyes the symptoms were attributed to a single mechanical obstruction. Seven eyes had canalicular stenosis. Three eyes had upper nasolacrimal duct obstruction. Nine eyes had narrow duct and nine eyes had atresia of the distal end of the duct. Two eyes had only intranasal abnormalities. In 16/52 (30.76%) eyes a combination of anomalies was responsible for the symptoms. Nine eyes had canalicular stenosis in association with: either a membrane at the valve of Hasner in four, or a narrow duct in three, or intranasal anomalies in two. Two eyes had punctual stenosis and narrow duct. Two eyes had narrow duct and tight inferior turbinate. Three eyes had abnormal openings in association with stenotic ducts. Six (11.54%) eyes had functional blockage. With the use of endonasal endoscopy, intranasal anomalies identified in 12 eyes and treated in nine. One eye had large inferior conchae. One eye had inferior concha adherent to lateral nasal wall. One eye had redundant nasal mucosa. Three eyes had tight inferior turbinate. Three had abnormal openings. In three eyes the probe went submucosally. The overall success rate was 84.6% (44/52 eyes). Eight eyes remained unchanged. Endoscopically treated cases contributed to the overall success by 17.31%.

CONCLUSION

Multiple anatomical anomalies within the lacrimal system and abnormalities of the nose are quite common in older children. Lacrimal probing remains the primary treatment and nasal endoscopy is a useful adjunct to probing increasing the success rate of the procedure.

Authors+Show Affiliations

Ophthalmology Department, "P.& A. Kyriakou" Children's Hospital, Athens, Greece. kougath@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18440076

Citation

Kouri, A S., et al. "Results of Endoscopic Assisted Probing for Congenital Nasolacrimal Duct Obstruction in Older Children." International Journal of Pediatric Otorhinolaryngology, vol. 72, no. 6, 2008, pp. 891-6.
Kouri AS, Tsakanikos M, Linardos E, et al. Results of endoscopic assisted probing for congenital nasolacrimal duct obstruction in older children. Int J Pediatr Otorhinolaryngol. 2008;72(6):891-6.
Kouri, A. S., Tsakanikos, M., Linardos, E., Nikolaidou, G., & Psarommatis, I. (2008). Results of endoscopic assisted probing for congenital nasolacrimal duct obstruction in older children. International Journal of Pediatric Otorhinolaryngology, 72(6), 891-6. https://doi.org/10.1016/j.ijporl.2008.02.024
Kouri AS, et al. Results of Endoscopic Assisted Probing for Congenital Nasolacrimal Duct Obstruction in Older Children. Int J Pediatr Otorhinolaryngol. 2008;72(6):891-6. PubMed PMID: 18440076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of endoscopic assisted probing for congenital nasolacrimal duct obstruction in older children. AU - Kouri,A S, AU - Tsakanikos,M, AU - Linardos,E, AU - Nikolaidou,G, AU - Psarommatis,I, Y1 - 2008/04/25/ PY - 2007/12/20/received PY - 2008/02/27/revised PY - 2008/02/28/accepted PY - 2008/4/29/pubmed PY - 2008/10/22/medline PY - 2008/4/29/entrez SP - 891 EP - 6 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 72 IS - 6 N2 - PURPOSE: To evaluate the results of lacrimal probing with the use of nasal endoscopy and identify the anatomical anomalies responsible for the symptoms in older children. METHODS: Fifty-two eyes of 40 children with congenital nasolacrimal duct obstruction underwent primary probing of the lacrimal duct under general anaesthetic in conjunction with nasal endoscopy. Patients followed up for at least 6 months. Cure was defined as complete resolution of symptoms or minimal symptoms brought on by cold or wind. RESULTS: The age range was 12-126 months. In 30/52 (57.7%) eyes the symptoms were attributed to a single mechanical obstruction. Seven eyes had canalicular stenosis. Three eyes had upper nasolacrimal duct obstruction. Nine eyes had narrow duct and nine eyes had atresia of the distal end of the duct. Two eyes had only intranasal abnormalities. In 16/52 (30.76%) eyes a combination of anomalies was responsible for the symptoms. Nine eyes had canalicular stenosis in association with: either a membrane at the valve of Hasner in four, or a narrow duct in three, or intranasal anomalies in two. Two eyes had punctual stenosis and narrow duct. Two eyes had narrow duct and tight inferior turbinate. Three eyes had abnormal openings in association with stenotic ducts. Six (11.54%) eyes had functional blockage. With the use of endonasal endoscopy, intranasal anomalies identified in 12 eyes and treated in nine. One eye had large inferior conchae. One eye had inferior concha adherent to lateral nasal wall. One eye had redundant nasal mucosa. Three eyes had tight inferior turbinate. Three had abnormal openings. In three eyes the probe went submucosally. The overall success rate was 84.6% (44/52 eyes). Eight eyes remained unchanged. Endoscopically treated cases contributed to the overall success by 17.31%. CONCLUSION: Multiple anatomical anomalies within the lacrimal system and abnormalities of the nose are quite common in older children. Lacrimal probing remains the primary treatment and nasal endoscopy is a useful adjunct to probing increasing the success rate of the procedure. SN - 0165-5876 UR - https://www.unboundmedicine.com/medline/citation/18440076/Results_of_endoscopic_assisted_probing_for_congenital_nasolacrimal_duct_obstruction_in_older_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(08)00115-8 DB - PRIME DP - Unbound Medicine ER -