Congenital Nasolacrimal Duct Obstruction

Weiss, Avery H.; Baran, Francine; Kelly, John P.

doi:10.1001/archophthalmol.2012.36

Cited by 34 publications

(16 citation statements)

References 15 publications

(18 reference statements)

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“…The pathogenesis of CNLDO lies in a mechanical obstruction located distally in the nasolacrimal duct (NLD) at the valve of Hasner, where this structure enters the nose [4]. Furthermore, most of the evidence would show the main causes of obstruction as either a pathological persistence of the membrane at the distal portion of the NLD, some bone abnormalities, or a stenosis of the inferior meatus leading to a narrowing in the lacrimal drainage system [5,6]. Moreover, the higher prevalence of CNLDO reported in premature infants compared with ones at full-term suggests the importance of the physiological development of the nasolacrimal drainage system during intrauterine life, in order to ensure the patency of the NLD [7].…”

Section: Introductionmentioning

confidence: 99%

Congenital Nasolacrimal Duct Obstruction (CNLDO): A Review

et al. 2018

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Congenital nasolacrimal duct obstruction (CNLDO) is a common condition causing excessive tearing or mucoid discharge from the eyes, due to blockage of the nasolacrimal duct system. Nasolacrimal duct obstruction affects as many as 20% children aged <1 year worldwide and is often resolved without surgery. Available treatment options are conservative therapy, including observation, lacrimal sac massage and antibiotics, and invasive therapy. Observation, combined with conservative options, seems to be the best option in infants aged <1 year. Meanwhile, in children aged >1 year, nasolacrimal probing successfully addresses most obstructions. However, the most favorable timing for probing remains controversial. To alleviate persistent epiphora and mucous drainage that is refractory to probing, repeat probing, silicone tube intubation, balloon catheter dilation or dacryocystorhinostomy can be considered as available treatment options. Our review aims to provide an update to CNDO management protocols.

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Section: Introductionmentioning

confidence: 99%

Congenital Nasolacrimal Duct Obstruction (CNLDO): A Review

et al. 2018

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“…Furthermore, the diameter of most nasolacrimal probes is only about 0.8 mm, while the diameter of the nasolacrimal canal in children is approximately 3 mm and larger than 3 mm in adults. [ 2 , 4 , 32 ] Intubation or probing will easily result in adhesion at Hasner valve position, which may cause re-obstruction consequently.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hasner valvulotomy outcomes in pediatric and adult patients: does age matter?

Sun

Ding²,

et al. 2020

Chinese Medical Journal

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Background Hasner valve incision has been recently introduced as a new treatment for ophthalmic patients with epiphora symptoms. The aim of this study was to examine whether surgical outcomes of Hasner valve incision for inferior nasolacrimal duct obstruction were different between pediatric and adult patients. Methods A total of 53 eyes of 52 patients who underwent Hasner valve incision in the Beijing Tongren Hospital from October 2016 to November 2019 were retrospectively observed. Patients were divided into two groups, including pediatric group (23 eyes of 22 patients, <18 years old) and adult group (30 eyes of 30 patients, ≥18 years old). Success rate of surgery was determined by both subjective measure (complete resolution of epiphora) and objective measure (lacrimal passage irrigation and tear meniscus height). Fisher exact test was conducted. Results By conducting Fisher exact test and comparing complete resolution of epiphora ( P = 0.627), lacrimal passage irrigation ( P = 0.663), measurement of Tear Meniscus Height ( P = 0.561), and appearance of complication ( P = 0.339), there was no statistically significant difference of surgical outcomes between pediatric and adult patients ( P > 0.05). Conclusion Hasner valve incision was effective for both adult and children with inferior nasolacrimal duct obstruction, with no difference in surgical outcomes between the two groups.

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“…Its main function is tear drainage. Due to the diverse bone structure of different individuals, the shape, size, and localization of the NLD may vary (9)(10)(11). CT is an imaging modality that can reveal the structure and pathological changes in the NLD.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have stated that NLD anatomy may vary according to sociodemographic features like age, race, and gender (9)(10)(11)15). In the literature, there are several studies that have evaluated the anatomical parameters of the bony NLD in the adult population.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Parameters of Nasolacrimal Duct Evaluated by Computed Tomography in Healthy Children

Altınkaynak¹

2019

Beyoglu Eye J

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This study is an evaluation of anatomical parameters at different levels of the bony nasolacrimal duct (NLD) in healthy children of different age groups using computed tomography (CT) measurements. Methods: Bony NLD CT images of 289 patients aged 0-15 years who presented at the emergency department with various indications and underwent a brain CT scan were retrospectively evaluated. The anterior-posterior and transverse diameter at the inferior orbital margin, the narrowest diameter of the NLD, NLD length, and the orientation angle in the sagittal plane (the angle between the line connecting the distal and proximal ends of the NLD and a line drawn parallel to the nasal floor) were analyzed by age group. Results: The anterior-posterior and transverse diameters at the level of the inferior orbital margin and the NLD length recorded in sagittal CT images were statistically significantly greater in patients older than 5 years of age (p<0.05). While there was an increase in the narrowest diameter of the NLD beginning at the age of 3 years, it was not statistically significant (p=0.25). The degree of the angle between the central line and the nasal floor did not change significantly between the groups. (p>0.05). Conclusion: A greater anterior-posterior diameter, transverse diameter, narrowest diameter of the NLD, and NLD length were observed with increasing age. The NLD anatomical parameters that we have identified in healthy children may serve as an important and useful guide in determining locations of the NLD and selecting surgical instruments of appropriate size and diameter before NLD surgery.

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Congenital Nasolacrimal Duct Obstruction

Abstract: This study provides anatomic evidence of a bony or membranous obstruction at the distal portion of the NLD or of a postductal obstruction at the inferior meatus in children with congenital NLD obstruction.

Cited by 34 publications

References 15 publications

Congenital Nasolacrimal Duct Obstruction (CNLDO): A Review

Congenital Nasolacrimal Duct Obstruction (CNLDO): A Review

Comparison of Hasner valvulotomy outcomes in pediatric and adult patients: does age matter?

Anatomical Parameters of Nasolacrimal Duct Evaluated by Computed Tomography in Healthy Children

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