Dacryostenosis in Newborns: Probing, or Syringing, or Both?

2000 ◽  
Vol 10 (2) ◽  
pp. 128-131 ◽  
Author(s):  
A.A. Tahat

Purpose This prospective study was designed to establish whether it is more effective to treat symptomatic congenital nasolacrimal duct obstruction by probing, or high-pressure irrigation, or both. Methods During the period February 1991 to January 1999, 228 infants (300 nasolacrimal ducts) were examined (132 males, 96 females, age range 12–13 months). These patients were divided into three groups of 100 ducts each. The first group was probed only; in the second group the nasolacrimal ducts were irrigated under high pressure using methylene blue-stained saline, and the third group was probed and irrigated in the same setting. The procedures were done under light general anesthesia. Results Ninety-one ducts in the first group improved after probing. In the second group 64 ducts improved after irrigation. In the third group 96 ducts improved after both probing and irrigation. Conclusions To treat symptomatic congenital nasolacrimal duct obstruction, it is more effective to combine high-pressure irrigation and probing. This gives a better success rate, first in treatment and secondarily, permitting intraoperative verification of the patency of the excretory lacrimal system.

2021 ◽  
Vol 28 (06) ◽  
pp. 804-807
Author(s):  
Mohammad Alam

Objective: To analyse the efficacy of non-surgical Crigler massage for treatment of congenital nasolacrimal duct obstruction in infants below one year age. Study Design:  Setting: Khyber Medical University Institute of Medical Sciences (KMU-IMS) KDA Teaching Hospital Kohat. Period: April 2014 to June 2019.  Materials & Methods:  on Non-Surgical Crigler massage for conservative   treatment of congenital nasolacrimal duct obstruction in infants below one year age. Proper proforma was designed for documentation of patients and their follow up. Consents were taken from their parents. 93 patients with age range of 2-6 months with congenital nasolacrimal duct obstruction were included in the study out of which 51(54.83%) were male and 42(45.16%) were female. 79(84.94%) patients had unilateral while 14(15.05%) patients had bilateral congenital nasolacrimal duct obstruction. So total 107 eyes with congenital nasolacrimal duct obstruction were included. Parents were trained and educated for conservative non-surgical Crigler massage of the lacrimal sacs along with topical antibiotics. Parents were instructed to do 8-10 massage four times a day. Patients were followed up to one year of age. 11 patients were lost from complete follow up in which 9 had unilateral while 2 patients had bilateral congenital nasolacrimal duct obstruction. Cumulatively 13 eyes were missed from follow up. Final results of remaining 82 patients with 94 eyes were analysed. Results: Out of 94 eyes epiphora was abolished with negative regurgitation test in 68(72.34%) patients at the end of one year while in 26(27.65%) the procedure was failed. Conclusion: Non-surgical conservative Crigler massage is very successful in management of congenital nasolacrimal duct obstruction.


2013 ◽  
Vol 127 (8) ◽  
pp. 794-798 ◽  
Author(s):  
S Theodoropoulou ◽  
M S M Sutherland ◽  
K Haddow ◽  
A Blaikie

AbstractObjective:To determine the success rate of initial probing in children with congenital nasolacrimal duct obstruction at different ages, using nasal endoscopy.Methods:Fifty eyes of 38 consecutive children with congenital nasolacrimal duct obstruction underwent endoscopic nasolacrimal duct probing under general anaesthesia. Patients were followed up for at least three months. Probing success was defined as complete remission of symptoms and a normal fluorescein dye disappearance test result.Results:The age range of patients was 17–109 months. The success rates of probing were: 100 per cent (29 out of 29) for cases of stenosis at the lower nasolacrimal duct, 100 per cent (7 out of 7) for functional epiphora cases and 92.86 per cent (13 out of 14) for nasolacrimal atresia cases. Overall, there was only one child for whom the probing treatment for nasolacrimal duct obstruction was not successful; this child had Down's syndrome and a more complex developmental abnormality of the nasolacrimal duct. Age and site of obstruction were not found to significantly affect the outcome of probing.Conclusion:Probing of the nasolacrimal system using an endoscopic approach allows direct visualisation of the nasolacrimal duct. This can facilitate diagnosis of the anomaly and significantly increase the procedure success rate.


2019 ◽  
Vol 104 (8) ◽  
pp. 1161-1163
Author(s):  
Tomomichi Nakayama ◽  
Akihide Watanabe ◽  
Saul Rajak ◽  
Yukito Yamanaka ◽  
Chie Sotozono

PurposeTo investigate spontaneous resolution of congenital nasolacrimal duct obstruction (CNLDO) beyond 12 months of age in Japanese infants.MethodsRetrospective, observational case series. We retrospectively reviewed the clinical records of patients diagnosed with CNLDO beyond 12 months of age at Kyoto Prefectural University Hospital, Kyoto, Japan. This study involved 155 cases of CNLDO in 133 Japanese infants diagnosed with CNLDO. All patients chose intervention with either dacryoendoscopic guided probing and stenting or conservative management. The proportion and age of patients who had spontaneous CLNDO resolution were analysed.ResultsThe patients were divided into two groups: (1) 62 patients with 70 obstructed nasolacrimal ducts (45%) in whom spontaneous resolution occurred and (2) 71 patients with 85 obstructed nasolacrimal ducts (55%) who underwent dacryoendoscopic guided probing and stenting. The mean age of spontaneous resolution was 17.8±5.3 months (range: 12.0–35.4 months). Dacryoendoscopic guided probing and stenting were successful in 83/85 (97.6%) of cases.ConclusionsSpontaneous resolution of CNLDO can occur in 45% of infants over the age of 12 months. Dacryoendoscopic guided stenting also has high success rates in this patient group, and both treatment options can be proposed to caregivers.


2005 ◽  
Vol 15 (2) ◽  
pp. 179-185 ◽  
Author(s):  
D. Yüksel ◽  
K. Ceylan ◽  
O. Erden ◽  
R. Kiliç ◽  
S. Duman

Purpose To evaluate the safety and effectiveness of balloon dacryocystoplasty in the treatment of congenital nasolacrimal duct obstructions. Methods Balloon dacryocystoplasty was attempted in 25 eyes of 21 patients. The procedure was performed successfully in 24 eyes of 20 patients, age range 21–72 months. Nineteen eyes had no previous procedure. The mean age of this group was 43.9 months (range 36–72 months). Five eyes had failed probing of lacrimal system. The mean age of this group was 22.2 months (range 21–24 months). The authors performed balloon dacryocystoplasty under endoscopic guidance. Clinical success was defined as complete remission of epiphora within follow-up period of 7–34 months (mean 25.2 months). Results The authors performed balloon dacryocystoplasty in 24 eyes. The first procedure was successful in 20 of them and the clinic success rate was 83.3%. The technique was repeated in the one eye that recurred and as it ended successfully, the clinic success rate increased to 87.5%. In 17 of the 19 eyes (89.4%) in which balloon dacryocystoplasty was performed primarily, and in 4 of 5 eyes (80%) in which balloon dacryocystoplasty was performed secondarily after unsuccessful probing, the procedure was clinically successful. There was intermittent epiphora in 3 eyes (15%) and these were considered as recurrence. Conclusions This experience shows that balloon dilatation is a safe and effective treatment of congenital nasolacrimal duct obstruction as a primary procedure in children over 36 months of age and as a secondary procedure after failure of lacrimal system probing. As a result, balloon dacryocystoplasty can be an alternative treatment in older children and can be preferred to silicone intubation and dacryocystorhinostomy performed after unsuccessful probing.


2001 ◽  
Vol 11 (3) ◽  
pp. 215-217 ◽  
Author(s):  
M. Orhan ◽  
P. Çal ◽  
M. Önerci ◽  
M. Írkeç

Purpose To compare conventional and endoscopic probing for congenital nasolacrimal duct obstruction in infants. Methods Conventional probing was performed in 22 eyes of 18 patients, age range 7–14 months (mean 11.4 months). Probing was done with intranasal endoscopic visualization in 18 eyes of 14 patients, age range 7–13 months (mean 11.2 months). All were primary probing cases. Results After conventional probing 2 of the 22 cases required reprobing. After endoscopic probing only 1 of the 18 cases required reprobing. Conclusions In most cases of congenital nasolacrimal duct obstruction endoscopy is not required; however, in failed cases direct visualization of the inferior meatus with endoscopic guidance may be helpful.


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