Pediatric nasolacrimal duct obstruction-benefit of a combined therapeutic approach

World J Pediatr. 2017 Oct;13(5):427-432. doi: 10.1007/s12519-017-0041-6. Epub 2017 May 24.

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.

Keywords: Hasner valve; dacryocystocele; nasal endoscopy; nasolacrimal duct probing; pediatric nasolacrimal duct obstruction.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Dacryocystorhinostomy* / methods
  • Endoscopy
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lacrimal Duct Obstruction / therapy*
  • Male
  • Retrospective Studies
  • Treatment Outcome