Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal canal dysplasia: A retrospective analysis in 40 children

Abstract Purpose: To investigate the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy (EN-DCR) to treat congenital nasolacrimal canal dysplasia (CNCD). Methods: Forty children (50 eyes) with congenital nasolacrimal duct obstruction (CNLDO) and lacrimal bony dysplasia, including 8 with bony atresia (10 eyes) and 32 with bony stenosis (40 eyes), were recruited in this retrospective study. Standardized EN-DCR was performed in all cases. The post-operative observations included relief of symptoms, fluorescein dye disappearance test (FDDT), syringing of lacrimal passages and anastomotic patency under nasal endoscopy. Patients were followed up for 8-18 months. Results: The standardized EN-DCR surgery had a success (cure and improvement) rate of 100%, including a cure rate of 82% and an improvement rate of 18%. The cure rate of 40 bony nasolacrimal duct stenosis was 82.5% and 10 bony nasolacrimal duct atresia was 80%. Statistical analysis showed that nether the receipt of other treatments before surgery nor the type of bony nasolacrimal duct dysplasia affected the cure rate. No significant complications were observed during the post-operative follow-up, except for four cases (4 eyes) that suffered middle turbinate and nasal mucosal adhesion and two cases with sinusitis. Conclusions: CNCD is a type of CNLDO that does not respond to conservative and conventional treatment. EN-DCR provides a safe and effective treatment for children with CNCD. It has a high success rate with a low incidence of complications.

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Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal canal dysplasia: a retrospective analysis in 40 children

BMC Ophthalmology ◽

10.1186/s12886-019-1256-1 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Yan-Hui Cui ◽

Cheng-Yue Zhang ◽

Wen Liu ◽

Qian Wu ◽

Gang Yu ◽

...

Keyword(s):

Middle Turbinate ◽

Ct Scanning ◽

Nasolacrimal Duct ◽

Cure Rate ◽

Improvement Rate ◽

Endoscopic Dacryocystorhinostomy ◽

Nasolacrimal Duct Stenosis ◽

Low Incidence ◽

Duct Stenosis

Abstract Background To investigate the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy (EN-DCR) to treat congenital nasolacrimal canal dysplasia (CNCD). Methods Forty children (50 eyes) with congenital nasolacrimal duct obstruction (CNLDO) and lacrimal bony dysplasia, including 8 children with bony atresia (10 eyes) and 32 with bony stenosis (40 eyes), were recruited in this retrospective study. Standardized EN-DCR was performed in all cases. The postoperative observations included relief of symptoms, fluorescein dye disappearance test (FDDT), syringing of lacrimal passages and anastomotic patency under nasal endoscopy. Patients were followed up for 8–18 months. Results Standardized EN-DCR surgery had a success (cure and improvement) rate of 100%, including a cure rate of 82% and an improvement rate of 18%. The cure rate among 40 cases of bony nasolacrimal duct stenosis was 82.5%, while that of 10 cases of bony nasolacrimal duct atresia was 80%. Statistical analysis showed that nether the receipt of other treatments before surgery nor the type of bony nasolacrimal duct dysplasia affected the cure rate. No significant complications were observed during postoperative follow-up except for four cases (4 eyes) that suffered middle turbinate and nasal mucosal adhesion and two cases with sinusitis. Conclusions CNCD is a type of CNLDO that does not respond to conservative and conventional treatment. EN-DCR represents a safe and effective treatment for children with CNCD. In addition, the combination of EN-DCR with lacrimal CT scanning provides advantages over traditional lacrimal surgery in that it has a high success rate with a low incidence of complications.

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Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal canal dysplasia: A retrospective analysis in 40 children

10.21203/rs.2.9757/v2 ◽

2019 ◽

Author(s):

Yan-Hui Cui ◽

Cheng-Yue Zhang ◽

Wen Liu ◽

Qian Wu ◽

Gang Yu ◽

...

Keyword(s):

Middle Turbinate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Nasal Endoscopy ◽

Cure Rate ◽

Improvement Rate ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Nasolacrimal Duct Stenosis

Abstract Background: To investigate the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy (EN-DCR) to treat congenital nasolacrimal canal dysplasia (CNCD). Methods: Forty children (50 eyes) with congenital nasolacrimal duct obstruction (CNLDO) and lacrimal bony dysplasia, including 8 children with bony atresia (10 eyes) and 32 with bony stenosis (40 eyes), were recruited in this retrospective study. Standardized EN-DCR was performed in all cases. The postoperative observations included relief of symptoms, fluorescein dye disappearance test (FDDT), syringing of lacrimal passages and anastomotic patency under nasal endoscopy. Patients were followed up for 8-18 months. Results: Standardized EN-DCR surgery had a success (cure and improvement) rate of 100%, including a cure rate of 82% and an improvement rate of 18%. The cure rate among 40 cases of bony nasolacrimal duct stenosis was 82.5%, while that of 10 cases of bony nasolacrimal duct atresia was 80%. Statistical analysis showed that nether the receipt of other treatments before surgery nor the type of bony nasolacrimal duct dysplasia affected the cure rate. No significant complications were observed during postoperative follow-up except for four cases (4 eyes) that suffered middle turbinate and nasal mucosal adhesion and two cases with sinusitis. Conclusions: CNCD is a type of CNLDO that does not respond to conservative and conventional treatment. EN-DCR represents a safe and effective treatment for children with CNCD. In addition, the combination of EN-DCR with lacrimal CT scanning provides advantages over traditional lacrimal surgery in that it has a high success rate with a low incidence of complications. Key words: nasal endoscopy; endoscopic dacryocystorhinostomy (EN-DCR); children; congenital nasolacrimal duct obstruction (CNLDO); nasolacrimal canal dysplasia

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Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal canal dysplasia: A retrospective analysis in 40 children

10.21203/rs.2.9757/v3 ◽

2019 ◽

Author(s):

Yan-Hui Cui ◽

Cheng-Yue Zhang ◽

Wen Liu ◽

Qian Wu ◽

Gang Yu ◽

...

Keyword(s):

Middle Turbinate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Nasal Endoscopy ◽

Cure Rate ◽

Improvement Rate ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Nasolacrimal Duct Stenosis

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Attachment-oriented Endoscopic Surgical Strategy for Sinonasal Inverted Papilloma

American Journal of Rhinology ◽

10.2500/ajr.2008.22.3243 ◽

2008 ◽

Vol 22 (6) ◽

pp. 629-634 ◽

Cited By ~ 25

Author(s):

Roee Landsberg ◽

Oren Cavel ◽

Yoram Segev ◽

Avi Khafif ◽

Dan M. Fliss

Keyword(s):

Frozen Section ◽

Attachment Site ◽

Nasolacrimal Duct ◽

Surgical Strategy ◽

Nasolacrimal Duct Stenosis ◽

The Mean ◽

The One ◽

A Prospective Study ◽

Duct Stenosis

Background It is well documented that inverted papillomas (IP) have a localized attachment site. Still, instead of concentrating on the attachment site, endoscopic surgeons often perform an extended resection similar to the one achieved after external surgery. Objective Our objective was to evaluate an attachment-oriented endoscopic surgical strategy and to determine IP attachment diameter and location. Methods A prospective study was conducted. Thirty-three consecutive patients who underwent endoscopic IP excision (2001-2007) were enrolled. Thirty patients had adequate follow-up. Attachment diameters were measured in 25/33 patients. Surgery included debulking, identifying the precise mucosal attachment site, subperiosteal dissection and excision of the attachment, frozen section control, and resection/drilling of underlying bone. Results The mean measured attachment diameter (n = 25) was 8.4 ± 6 mm (range, 3-23 mm). Attachment locations included maxillary sinus (39%), ethmoid sinus (21%), nasal cavity (21%), frontal sinus (6%), sphenoid sinus (6%), lamina papyracea (3%), and cribriform plate (3%). The mean follow-up (n = 30) was 40 ± 21 months. Three patients had Krouse stage 1, 10 patients had stage 2, and 17 patients had stage 3. Nine patients had undergone previous surgeries. After attachment-oriented endoscopic surgery, three patients had persistent disease. Nasolacrimal duct stenosis was the only complication (n = 1). Conclusion Even advanced IP have small attachments. Their Identification facilitates efficacious resection with minimal morbidity.

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Use of Oil as a Lubricant makes Lacrimal Sac Massage Efficient in Congenital NasoLacrimal Duct Obstruction (CNLDO)

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2014/v1/i1/830 ◽

2014 ◽

Vol 1 (1) ◽

pp. 13

Author(s):

Prachi Pawar ◽

Aruna Patil ◽

Mihir Patel ◽

Saurabh Shah

Keyword(s):

Specific Treatment ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Cure Rate ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Significant Difference ◽

Group A ◽

Group B

Introduction: Congenital NasoLacrimal Duct Obstruction (CNLDO) is a frequent entity in the paediatric age. CNLDO has a 20% to 30% incidence rate out of which only 1% to 6% become symptomatic.1 The 4% of premature infants are affected with CNLDO.2 The management of failed Crigler's Sac massage is probing, secondary probing, external DCR and with or without intubation is well known to all. To avoid the sequelae of CNLDO, cure of CNLDO is mandatory. Hence the aim of the study is primary cure for CNLDO by using specific treatment of Crigler's Sac massage with Oil is emphasised. Method: This study was about 140 eyes and in each group, 70 eyes were enrolled with lost to follow up considerations. Patients had been selected and randomised alternatively when visited ophthalmology OPD. The CNLDO patients were selected from the age group ranged 1 to 9 months. Follow up of all patients was taken every month up to 15 months of age. Each and every patient from both the groups had to complete the formality of clinical consultation, doctors counselling to parents specially mothers explaining the procedure of sac massage and taking a live demonstration by mother/ parent hence confirming the proper technique to be followed at home. Results: In group A, Standard Crigler's Method was used only on 54 eyes out of enrolment of 70 eyes. In group B, Standard Method with add on therapy of oil massage had been given to 66 eyes out of 70. In group B, cure rate was found in 60(91%) which was significantly differing from the cure rate of group A 30(56%) by Standard Crigler's Method at P<0.001. Complications were found in 20 eyes in group A and in group B only one patient showed complication unrelated to the treatment of CNLDO used by the patients in this group. No significant difference was seen in the sex distribution in relation to CNLDO at P>0.05. Conclusion: The primary need of Crigler's Sac Massage using Oil has given the importance towards good compliance and success of curing CNLDO.

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Success Rate of Probing for Congenital Nasolacrimal Duct Obstruction in Children

Folia Medica ◽

10.2478/folmed-2018-0054 ◽

2019 ◽

Vol 61 (1) ◽

pp. 97-103 ◽

Cited By ~ 3

Author(s):

Krasina P. Valcheva ◽

Snezhana V. Murgova ◽

Emilia K. Krivoshiiska

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Cure Rate ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

History Of ◽

Group A ◽

Group B

Abstract Aim: To determine the success rate of initial and repeated probing for congenital nasolacrimal duct obstruction (CNLDO) in children between 2-41 months. Patients and methods: One hundred and twelve children aged 1.8 to 13 years responded to the control examination. They were diagnosed with CNLDO in the past and now included in a retrospective study. The mean follow-up period was 5.2 years (from 0.6 to 11.6 years). Patients were divided into two groups according to their age at the time of surgery: group A (2-12 months) and group B (13-41 months). Probing and irrigation of NLD was performed in the Eye Clinic in Pleven under general anesthesia in all subjects. A controlled examination was done to evaluate the effect of probing on the basis of a history of watery eyes, regurgitation test, and dye disappearance test (DTT). Results: Of the 131 eyes in 112 children, 110 eyes (84%) had one probing and 21 eyes (16%) had repeat probing. Success rate of the initial probing was 90% (99 of 110) for all patients’ eyes: 89% (70 of 79) in group A and 94% (29 of 31) in group B. The cure rate of the repeat probing was 76% (16 of 21) for all patients: 88% (7 of 8) in group A and 69% (9 of 13) in group B. The overall success rate of probing was 88% (115 of 131). Conclusion: Nasolacrimal duct probing followed by irrigation is a commonly performed, highly successful treatment for congenital nasolacrimal duct obstruction in children. The success rate for initial and repeated nasolacrimal duct probing is not affected by age.

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Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared with observation alone

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-318853 ◽

2021 ◽

pp. bjophthalmol-2021-318853

Author(s):

Brian G Mohney ◽

Saraniya Sathiamoorthi ◽

Ryan D Frank

Keyword(s):

Medical Records ◽

Population Based ◽

Nasolacrimal Duct ◽

Spontaneous Resolution ◽

Nasolacrimal Duct Obstruction ◽

Olmsted County ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Topical Antibiotics

Background/aimsTo determine if nasolacrimal massage or topical antibiotics are associated with higher rates of resolution compared with observation alone in a population-based cohort of infants with congenital nasolacrimal duct obstruction (CNLDO).MethodsThe medical records of all children <5 years diagnosed with CNLDO while residing in Olmsted County, Minnesota from 1 January 1995 through 31 December 2004 were retrospectively reviewed for type of management and non-surgical resolution of tearing.ResultsAmong 1958 infants diagnosed and followed for CNLDO, 516 (26.4%) were merely observed, 506 (25.8%) were prescribed massage alone, 485 (24.8%) were prescribed at least one course of topical antibiotics, 397 (20.3%) were prescribed both topical antibiotics and massage, and 54 (2.8%) had no documented therapy. Non-surgical resolution, occurring in 1669 (85.2%) during a median follow-up of 3.1 months (range: 1 week–248 months), was 74.6% for the merely observed, 89.7% for those prescribed digital massage, 87.0% for those prescribed antibiotics and 90.7% for those treated with both. This comparison was significant in unadjusted (p<0.001) and multivariable comparisons (p<0.001).ConclusionPrescribing topical antibiotics or digital massage for infants with CNLDO in this cohort, individually or in combination, was associated with a higher rate of spontaneous resolution than observation alone.

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Efficacy of probing adjunctive with low-dose mitomycin-C irrigation for the treatment of epiphora in adults with nasolacrimal duct stenosis

Taiwan Journal of Ophthalmology ◽

10.4103/tjo.tjo_25_20 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Babak Masoomian ◽

Bahram Eshraghi ◽

Golshan Latifi ◽

Hossein Esfandiari

Keyword(s):

Mitomycin C ◽

Low Dose ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Stenosis ◽

Duct Stenosis

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Non-Surgical Crigler massage for treatment of congenital nasolacrimal duct obstruction in infants below one year age.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.06.6216 ◽

2021 ◽

Vol 28 (06) ◽

pp. 804-807

Author(s):

Mohammad Alam

Keyword(s):

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Medical Sciences ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Topical Antibiotics ◽

One Year ◽

Medical University ◽

Age Range

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.

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Outcome of Probing for Congenital Naso-Lacrimal Duct Obstruction

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v14i1.22879 ◽

2015 ◽

Vol 14 (1) ◽

pp. 36-37

Author(s):

Mozammel Hoq Sharife ◽

M Jalal Uddin ◽

Mostak Ahmed

Keyword(s):

Nasolacrimal Duct ◽

Age Group ◽

Lacrimal Duct ◽

Female Ratio ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Male Female Ratio ◽

Group A ◽

Level Hospital

Objective: The study was conducted to evaluate outcome of probing for congenital nasolacrimal duct obstruction. It was an interventional study at a tertiary level hospital of Chittagong. Methods: The study was conducted during April 2009 to March 2013 (04 years). Total 120 eyes of 102 children of 1-3 years age group were probed. Minimum follow up time was 01 year. Results: 110 eyes fully cured, 05 eyes needed re-probing, 03 eyes needed Dacrocystorhinostomy operation (DCR) and 02 cases were dropped out. Male female ratio was 72 (60%) and 48 (40%). Conclusion: Outcome of probing is better among 1-2 years age group than that of 2- 3 years age group. A discussion is made with updated literature review. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22879 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 36-37

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