Behandlung kindlicher Tränenwegsstenosen

Heichel, Jens; Bachner, F.; Schmidt‐Pokrzywniak, Andrea; Struck, H.-G.; Stuhlträger, U; Bredehorn-Mayr, T.

doi:10.1007/s00347-015-0067-x

Cited by 16 publications

(9 citation statements)

References 25 publications

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“…Im Neugeborenen-und Kindesalter ist der Verschluss des Tränen-Nasen-Gangs an seiner Mündung in die Nasenhöhle durch die Persistenz der Hasner-Membran die häufigste Ursache für eine kongenitale Tränenwegsstenose (congenital nasolacrimal duct obstruction, CNLDO) [9,10]. Bei ausbleibender Besserung der klinischen Symptomatik nach Tränensackmassagen, antibiotischer Therapie und einer Überdruckspülung bis zum 1.…”

Section: Anwendungsmöglichkeiten Eines Neuartigen Vorgeladenen Intubaunclassified

Application Possibilities of a New Preloaded Nasolacrimal Duct Intubation System

Mihailovic

Grenzebach

Eter

et al. 2021

Klin Monbl Augenheilkd

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Introduction The LacriJet (FCI S. A. S. – France Chirurgie Instrumentation, Paris, France) represents a novel, simplified and preloaded system for monocanalicular or monocanaliculonasal nasolacrimal duct intubation. It is a further development of the Masterka and shall reduce the intubation time during the surgical procedure. The aim of the present study was to present first experiences with this system for different indications. Material and Methods All patients who underwent nasolacrimal duct intubation with the LacriJet at the University of Muenster Medical Center in the period from March to November 2019 were included. The postoperative outcome was evaluated 3 to 6 months later. Results In total, 12 nasolacrimal duct intubations with the LacriJet were performed at our center in the above-mentioned period. The main indication for intubation was congenital nasolacrimal duct obstruction (CNLDO). In addition, intubation was performed in cases with eye lid tumors involving the nasolacrimal duct, in a case of canalicular laceration and in a case of canaliculitis. In 3 cases, there was an early dislocation or a complete loss of intubation. Of these, 2 were cases with CNLDO and the third dislocation was due to manipulation by the patient. All in all, the functional results were satisfying. Summary The use of the LacriJet is highly suitable for the treatment of CNLDO, stenting in canalicular laceration or lid tumours involving the lacrimal drainage system. However, the known disadvantages of monocanalicular intubation (dislocation, early loss of intubation) also occur with this type of system and a system briefing seems useful. The LacriJet therefore represents a modern and simple method for nasolacrimal duct intubation and can be used for various indications.

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Section: Anwendungsmöglichkeiten Eines Neuartigen Vorgeladenen Intubaunclassified

Application Possibilities of a New Preloaded Nasolacrimal Duct Intubation System

Mihailovic

Grenzebach

Eter

et al. 2021

Klin Monbl Augenheilkd

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“…Befall kann hier ein Vergleich zur nicht betroffenen Seite vorgenommen werden. Es ist jedoch zu berücksichtigen, dass in bis zu 30 % eine beidseitige Manifestation vorzufinden ist [8]. Als weiteres klassisches klinisches Zeichen lassen sich mukopurulente Sekretionen nachweisen.…”

Section: Zur Embryologie Der Ableitenden Tränenwegeunclassified

“…Wird [15,22]. Genauso ist die Absicherung der TNW durch Silikonstützmaterialien nach 2-maliger erfolgloser Spülbehandlung zu empfehlen [8,15,22].…”

Section: Diagnostische Spülung Der Ableitenden Tränenwegeunclassified

“…Argumente dafür sind bisher erfolglos verlaufene Sondierungen bzw. ein Patientenalter über 24 Monate [8,45]. Die temporäre Schienung der TNW hat eine weitreichende Entwicklung durchlaufen.…”

Section: Diskussionunclassified

“…Auswahl möglicher Differenzialdiagnosen der Epiphora im Kindesalter zur konnatalen Dakryostenose[9]. So steigt mit jedem Monat das Risiko für eine erfolglose Anwendung der Spülhandlung um den Faktor 1,3[8]. Trotz einer höheren, wenn auch kurzzeitigen, akuten Stressbelastung im Vergleich zur Behandlung in Allgemeinanästhesie wird das Verfahren von Kindern und Eltern gut toleriert.…”

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Stufenkonzept zur Therapie der konnatalen Dakryostenose

Heichel

2017

Klin Monatsbl Augenheilkd

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Unresolved epiphora in childhood is one of the most frequent issues in paediatric ophthalmology. In this context, connatal nasolacrimal duct obstruction (CNLDO) is the most important differential diagnosis and the condition is caused by a persistent Hasner's membrane in most cases. As there is a risk of complications, treatment should be considered. Therapeutic options include conservative and invasive approaches. As CNLDO is associated with high spontaneous recovery rates during the first years of life, the indication for invasive interventions must be carefully deliberated in that period. Conservative treatment with digital compression of the lacrimal sac should be performed whenever CNLDO is suspected. Invasive treatment is recommended in case of complications such as acute dacryocystitis or recurrent ascending infections. Furthermore, CNLDO seems to be amblyogenic. In addition to probing and syringing, temporary intubation of the lacrimal duct is possible. Further transcanalicular approaches include dacryoendoscopy or balloon dacryoplasty. Dacryocystorhinostomy should be reserved for special indications, although it has a low rate of complications and treatment is successful in 90 % of cases. The available treatment approaches can be integrated into a graduated treatment concept, which is influenced by many factors and should therefore be individualised.

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