Pediatric Endonasal Dacryocystorhinostomy: A Report of 34 Cases

Abstract

EDCRs in children appear to provide a safe and successful procedure with the success rate comparable with those achieved with external DCRs and those in adults.

Lacrimal drainage obstruction and dacryocystorhinostomy in children

“…2,3,6 However, endo-DCR in children has been reported to be safe with a success rate of 89% or better regardless of age, comparable to that achieved with external DCR and that of endo-DCR in adults. 1 The main advantage of external DCR is visualization of the anatomy, allowing precise removal of bone in the lacrimal sac fossa, and accurate suture-fixated anastomosis of the nasal mucosa and lacrimal sac. 25 In addition, surgeons are able to excise any membrane covering the opening of the common canaliculus into the sac and can inspect the sac for unexpected pathology.…”

“…Conservative medical therapy with hydrostatic pressure on the lacrimal sac, topical antibiotics, probing, and silicone intubation if necessary, are usually effective in clearing the obstruction. [1][2][3][4][5][6] DCR is required only rarely for recalcitrant cases. Other indications for paediatric DCR are traumatic obstructions, punctal/canalicular agenesis; cases associated with other systemic (eg cleft) anomalies, and acquired cases of NLDO.…”

“…Other indications for paediatric DCR are traumatic obstructions, punctal/canalicular agenesis; cases associated with other systemic (eg cleft) anomalies, and acquired cases of NLDO. 1,4 In recent years, DCRs in adults have increasingly been performed endoscopically and studies have shown that the success rates of external and endoscopic DCRs have been comparable. 7,8 The reports on endoscopic DCR in children are limited.…”

“…7,8 The reports on endoscopic DCR in children are limited. Recent works have shown favourable results with success rates of 82-88% for endoscopic DCR in children, 1,2,[5][6][7] with no added difficulties or differences in the procedure as compared with adults. 1 The aetiology of NLDO is mostly different for the paediatric group, and there are some important anatomical differences to consider, including a narrowed nasal cavity.…”

“…Recent works have shown favourable results with success rates of 82-88% for endoscopic DCR in children, 1,2,[5][6][7] with no added difficulties or differences in the procedure as compared with adults. 1 The aetiology of NLDO is mostly different for the paediatric group, and there are some important anatomical differences to consider, including a narrowed nasal cavity. 9,10 The present study is a review of paediatric external and endoscopic DCRs performed to address various etiologies of NLDO and surgical outcome in the paediatric group of a tertiary referral centre.…”