Investigating the Role of Metal Fatigue in a Case of Ritleng Probe Fracture

Abstract

Complications with the Ritleng probe have not been reported previously. Herein, we report a case in which the Ritleng probe tip fractured during use on a patient undergoing nasolacrimal duct intubation requiring subsequent retrieval. A root-cause analysis was conducted which help to elicit possible ways to prevent such a complication in the future. Most notably the use of the stylet, documented as a cleaning device, seems to offer additional support to prevent metal fatigue and tip fracture.

Retrospective analysis of silicon intubation by Ritleng probe and Sutupak suture fixed in silicone tube in congenital nasolacrimal duct obstruction

“…have described fracture of Ritleng probe tip during intubation requiring subsequent removal of fractured tip. [ 14 ] We too encountered similar complication in one case requiring subsequent external DCR to retrieve the fractured tip from the duct under general anesthesia.…”

“…Silicone tube intubation using the Ritleng system has been described before in the treatment of persistent CNLDO in children. [ 8 9 10 11 12 13 14 15 ] The Ritleng probe is a long and hollow metallic tube and allows passage of a suture through it easily. Most authors claim a high success rate of resolution using this technique obviating the need for DCR, which is a more invasive procedure and is best avoided if possible.…”