Paediatric powered endonasal dacryocystorhinostomy

Abstract

Dacryocystorhinostomy (DCR) is indicated in children with persistent nasolacrimal duct obstruction (NLDO). Endoscopic endonasal DCR has been successfully performed in both adults and children, with success rates similar to that of external DCR. This paper aims to evaluate the outcomes of paediatric patients undergoing endonasal endoscopic DCR at a district general hospital. A retrospective review of all patients attending a joint lacrimal clinic undergoing endonasal endoscopic DCR between October 2001 and December 2008 was performed. Sixteen children (17 eyes) aged between 2 and 14 were analysed. The main outcome measure was resolution of symptoms. Fourteen cases (82%) presented with epiphora with or without stickiness. Three cases had recurrent dacryocystitis. Three patients had Down syndrome. There were no operative complications. During a mean post-operative period of 12 months, all but one case showed an improvement of symptoms. While 60% of the patients had a complete resolution of symptoms, the remaining were minimally symptomatic. Of those with residual symptoms, two had Down syndrome. Endonasal DCR is a safe and effective intervention for children with persistent NLDO. Success is higher in children with no craniofacial abnormality. Joint care under a consultant Oculoplastic and ENT surgeon provides optimum care for these patients.

Pattern and outcome of surgical management of nasolachrymal duct obstruction in children: A five year review

“…Endocanalicular diode laser DCR is an effective treatment for pediatric patients with congenital NLDO and offers shorter operative time with less morbidity. [21] Another option is endonasal laser (ENL-DCR) which employs potassium-titanyl-phosphate laser. [22] Equipment required for most of these modern surgical methods is unavailable in our setting.…”

Primary Endoscopic Endonasal Dacryocystorhinostomy for Pediatric Nasolacrimal Duct Obstruction: A Systematic Review

“…Although most of the series did not specify the cause of NLDO, we found that EDCR, overall, most commonly was warranted in the patients with congenital NLDO ( n = 200). 12–18 In one series, however, idiopathic NLDO ( n = 10) was found to be the most common indication for EDCR. 7 Other indications were trauma, iatrogenic causes, craniofacial abnormalities, and infection.…”