A Novel One-Stage Obstruction-Based Endoscopic Approach to Congenital Nasolacrimal Duct Obstruction

Kashkouli, Mohsen Bahmani; Abtahi, Mohammad Bagher; Sianati, Hamed; Mahvidizadeh, Nina; Pakdel, Farzad; Kashkouli, Pedram Bahmani; Abdolalizadeh, Parya

doi:10.1097/iop.0000000000000788

Cited by 17 publications

(26 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The endoscopic DCR has become a well-accepted and a safe surgical technique for management of NLD obstruction with high success rates of around 90% in adult [15][16][17] . The endoscopic DCR to CNLDO has been operated for infants recently 18,19) . Although in young patients the nasal anatomy is more complex and narrow than in adults, the endoscopic DCR to CNLDO allows similar success rates of around 90 % 18,19) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nasolacrimal duct opening to the inferior nasal meatus in human fetuses

Honkura

Takanashi

Hirano-Kawamoto

et al. 2017

Okajimas Folia Anat. Jpn.

View full text Add to dashboard Cite

Summary: The purpose of this study is to describe the Hasner's membrane which is the main factor of congenital nasolacrimal duct obstruction. Hasner's membrane at the nasal end of the fetal nasolacrimal duct (NLD) is considered to rupture at and after birth. However, topographical anatomy around the membrane as well as a mechanism of rupture seems to be still obscure. We observed frontal or sagittal sections of 20 late-stage fetuses (28-33 weeks) and found the on-going rupture in 2 specimens. The present sections demonstrated that 1) the nasal dilation was not a simple ball-like structure but extended posteriorly and laterally; 2) dilation of the NLD consistently involved the lacrimal sac; 3) Hasner's membrane and ductal mucosal layer contained no macrophages and no or few arteries and nerves. The posterior extension of the NLD end ranged from 1-2 mm, while the lateral extension 3-5 mm although a site of the thinnest membrane varied in location between specimens. Moreover, the thickest NLD due to dilation was in the slightly orbital or upper side of the nasal end. Therefore, before surgical treatment of Hasner's membrane, evaluation using medical images seems to be necessary. Since the nasal epithelium on Hasner's membrane was most likely to destroy earlier than the NLD mucosal lining, observations of the membrane from the nasal cavity seemed helpful for diagnosis at which site would be broken and when.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The endoscopic DCR to CNLDO has been operated for infants recently 18,19) . Although in young patients the nasal anatomy is more complex and narrow than in adults, the endoscopic DCR to CNLDO allows similar success rates of around 90 % 18,19) .…”

Section: Discussionmentioning

confidence: 99%

Nasolacrimal duct opening to the inferior nasal meatus in human fetuses

Honkura

Takanashi

Hirano-Kawamoto

et al. 2017

Okajimas Folia Anat. Jpn.

View full text Add to dashboard Cite

show abstract

“…These can contribute to persistent epiphora after a simple probing of the nasolacrimal duct. 12 Endoscopically-controlled probing of nasolacrimal duct identifies false passage and results in a higher rate of success. 13 It is not unusual for children to undergo multiple procedures such as probing, re-probing, followed by probing with inferior turbinate fracture, then intubation, and finally DCR.…”

Section: Lacrimal Drainage Systemmentioning

confidence: 99%

“…Considering the resources needed to be used and the increased chance of morbidity, especially general anaesthesia in childhood, this has become an unacceptable practice. Therefore, one-stage, obstruction-based endoscopic CNLDO surgery 12 is becoming more prevalent. In this approach, examination under general anaesthesia of the drainage system and nasal cavity utilizing the endonasal endoscope is performed.…”

Section: Lacrimal Drainage Systemmentioning

confidence: 99%

Endoscopy in the field of oculo-facial plastic surgery

Kashkouli

Beigi

2018

Journal of Current Ophthalmology

Self Cite

View full text Add to dashboard Cite

“…[1234] The complex variety is associated with anlages/fistulas, systemic syndromes (Down, Treacher-Collins, Fraser, Rubinstein-Tyabi) or craniofacial abnormalities/syndromes. [567]…”

mentioning

confidence: 99%

Nasal endoscopic features and outcomes of nasal endoscopy guided bicanalicular intubation for complex persistent congenital nasolacrimal duct obstructions

Singh

Sharma

Kaur

et al. 2019

Indian J Ophthalmol

View full text Add to dashboard Cite

Purpose: To study the clinical presentation, nasal endoscopic features, and outcomes of nasal endoscopy guided (NEG) bicanalicular intubation (BCI) in children with complex persistent congenital nasolacrimal duct obstruction (pCNLDO). Methods: A prospective, interventional study including eligible children (age ≤ 12 years) having complex pCNLDO. The demographics, number of previous probings, nasal endoscopy findings, and outcomes; were noted in all children who underwent NEG-BCI with Crawford's stents. Matting of eyelashes (MoE, upper, and lower eyelid), tear-film height (TFH), and fluorescein dye disappearance test (FDDT) was assessed pre and postoperatively. The minimum stent in-situ period was 12 weeks, and the minimum follow-up was 6 months (after stent removal). Results: Total 32 children (36 eyes) including 18 females (56.25%) were studied. At a mean age of 4.9 years, all children had epiphora and discharge with MoE (both upper and lower), raised TFH and positive FDDT. Previously, all children underwent conventional probing (s)- once in 12 (33.3%), twice in 18 (50%) and thrice in 6 (16.7%) eyes. The general ophthalmologists performed the majority ( n = 21, 58.33%) of those. The BCI was performed under GA in all eyes, and at a mean follow-up of 8.5 months, the “complete” success was noted in 29 eyes (80.5%), ‘partial’ success in 4 (11.1%) and failure in 3 (8.3%). The stent prolapse was seen in three. Conclusion: NEG-BCI may provide a satisfactory resolution to complex pCNLDO after single or multiple failed probings. NEG provides confident and efficient management of coexistent intranasal complexities related to the inferior turbinate and meatus.

show abstract

A Novel One-Stage Obstruction-Based Endoscopic Approach to Congenital Nasolacrimal Duct Obstruction

Abstract: One-stage, obstruction-based endoscopic approach to CNLDO resulted in a high success rate for different types of CNLDO (membranous, incomplete complex, and complete complex). No variable significantly affected the success rates.

Cited by 17 publications

References 32 publications

Nasolacrimal duct opening to the inferior nasal meatus in human fetuses

Nasolacrimal duct opening to the inferior nasal meatus in human fetuses

Endoscopy in the field of oculo-facial plastic surgery

Nasal endoscopic features and outcomes of nasal endoscopy guided bicanalicular intubation for complex persistent congenital nasolacrimal duct obstructions

Contact Info

Product

Resources

About