Comparison of two endoscopically assisted procedures in primary surgical treatment of congenital nasolacrimal duct obstruction in children older than 3 years: Balloon dilatation and bicanalicular silicone tube intubation

Monocanalicular versus bicanalicular silicone intubation for congenital nasolacrimal duct obstruction

“…In our study, the success rate for BCI both as a primary and a secondary treatment compares favorably with the previously reported success rates, which have ranged from 62.5% to 100% for BCI in treatment of CNLDO. [11][12][13][14][15][16][17] In our study, the treatment success of MCI and BCI in complex obstruction was similar (87.5% vs 89%). However, our success rate in complex obstruction is less than that reported by Engel and colleagues, 10 who achieved a 95.3% success rate in complex obstruction with MCI.…”

“…In our study, tube loss was uncommon in both the MCI and the BCI groups (only 1 eye in each), compared with tube loss after MCI of 7.6% to 43.7% reported in other studies. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] The unplanned removal of a Crawford stent because of a dislodgment of the tube occurred in 3 of 27 eyes (11.1%), compared with tube dislodgment in 3.1% to 41% of cases reported in other studies. [11][12][13][17][18][19] Tube-associated infection occurred in only 1 eye with MCI (0.03%) and 2 eyes (0.07%) with BCI, compared with rates of tube-associated infection in other studies at 8.5% for MCI 4 and 3% for BCI.…”

Is There Any Evidence for Surgical Intervention in Childhood Epiphora?

“…50 A recent prospective randomised trial comparing transnasal endoscopic assisted balloon dilatation with bicanalicular silicone intubation for the primary surgical treatment of congenital nasolacrimal duct obstruction in children over three years of age identified that balloon dilatation was more effective (90%) than intubation (62.5%). 51 Although statistically significant, this study has small groups of 20-24 patients in each arm of treatment.…”

Balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction

“…Few studies have reported silicone intubation as the primary treatment for NLDO in older children. Ceylan et al 20 reported 62.5% success rate of bicanalicular silicone intubation in children older than 3 years. Andalib et al 9 reported the success rates of silicone intubation as the primary treatment in children older than 2 years with success rates of 92% and 82% for monocanalicular and bicanalicular, respectively.…”

“…9,10,20,21 After intubation, many infants still suffer from tearing, corneal abrasions, and infections until the tube is removed—a phenomenon that is absent after balloon dacryoplasty. 6–10,20 Finally, removal of the tube can be problematic in older children and may necessitate a second anesthesia. Although there may be fewer complications with monocanalicular stents versus bicanalicular, there is still a complication rate from maintaining a foreign body in the nasolacrimal duct.…”