Doğumsal Nazolakrimal Kanal Tıkanıklığı Tedavisinde Sondalama Yönteminin Etkinliği

Abstract

Sum maryPur po se: To investigate the outcome of probing in patients with congenital nasolacrimal duct obstruction and to evaluate the success rate among age groups. Ma te ri al and Met hod: The charts of patients who underwent probing for congenital nasolacrimal duct obstruction between 2008 and 2011 were reviewed. Patients' ages at the time of probing, the presence of watering complaints and epiphora, and fluorescein dye disappearance test results after the procedure were recorded. Findings were evaluated according to age groups. Re sults: Forty-six patients (24 girls (52.2%), 22 boys (47.8%)) diagnosed as congenital nasolacrimal duct obstruction were included in the study. Probing was performed to the right eye in 13 (28.3%), left eye in 13 (28.3%) and both eyes in 20 (43.4%) patients, i.e. to 66 eyes in total. Age at time of probing was between 18 days and 6 years (average: 23.5 months). Six patients were under 12 months, 26 patients were between 12 and 24 months, and 14 patients were over 24 months. Mean follow-up period was 4.32 (1-24) months. By probing, success was achieved in 48 of 66 eyes (72.72%). According to the age group, success rate of probing was 100% (6 of 6 eyes) in patients under 12 months, while it was 80.95% (34 of 42 eyes) in patients between 12-24 months and 44.44% (8 eyes of 18) in those over 24 months. Dis cus si on: In the first year of life, probing is an effective treatment for congenital nasolacrimal duct obstruction in cases not improving with conservative treatment. As the age increases, the chance of success decreases, thus the application should not be delayed. However, in selected cases with advanced age, it can be recommended prior to invasive treatments. (Turk J Ophthalmol 2012; 42: 342-5 GirişDoğumsal nazolakrimal kanal tıkanıklığı (DNKT) pediatrik hasta grubunda sıkça karşılaşılan, gözlerde sulanma, çapaklanma ve mükopürülan sekresyonla seyreden, çoğunlukla inflamasyon bulgusu olmasa da sekonder enfeksiyon gelişmesi durumunda konjonktivite, tedavi edilmediği taktirde dakriosistit, preseptal ve orbital sellülit gibi ciddi komplikasyonlara neden olabilecek önemli

Retrospective Evaluation of Surgical Methods and Outcomes of Pediatric Nasolacrimal Duct Obstruction According to Age Groups

“…evaluated the probing success in 105 eyes of 84 patients (mean 16.4 months old) according to the age groups, the success rate of probing was 86.7% in patients between 12-24 months and 57.7% in those over 24 months. Besides, Esen et al 8 . evaluated the probing success in 66 eyes of 46 patients (mean 23.5 months old) according to the age groups, the success rate was reported to be 100% in the patients below 12 months, 80.9% in the 12-24 months and 44.4% in those over 24 months.…”

“…conducted a study with 169 eyes of 125 patients (1-5 years old) and reported 89% success in the 13-24 months and 72% success in those over 24 months and found a statistically significant decrease in probing success with increasing age. In the literature, it has been shown that early treatment therapy is more effective in many studies 8,[16][17][18][19][20][21] . In our study, success was achieved in patients younger than 12 months with probing according to the literature.…”

“…Therefore, conservative treatment methods are recommended in the first year 7 . However, in the presence of additional pathologies such as mucocele, dacryocystocele, and severe infection, probing should be performed without waiting for one year 7,8 . There is no definite age range related to probing time in the literature.…”

“…It has been reported in many studies that the nasolacrimal duct (NLD) probing has a high success rate in the first year of life. However, success rate decreases with increasing age 8,9 . If the watering continues and the patients older than 1 year and unresponsive to conservative treatment, the NLD probing should be performed 7 .…”

Konjenital nazolakrimal kanal tıkanıklığında sondalama cerrahisinin yaş aralıklarına göre başarı oranlarının karşılaştırılması

“…The most common type is membranous occlusion at the level of Hasner's valve [11][12][13] . The management of congenital nasolacrimal duct obstruction remains controversial because spontaneous resolution reportedly occurs in up to 90% of patients by the age of 12 months [13][14][15] . Spontaneous resolution with conservative treatment in the second year of life has not been extensively reported [14][15][16][17] .…”