The role of nasolacrimal intubation in the management of childhood epiphora

Abstract

Nasolacrimal intubation has been advocated to obviate the need for dacryocystorhinostomy (DCR) for childhood epiphora which fails to resolve despite apparently successful probings. Twenty-eight intubations were attempted on children falling into this category. Of these, 25 were anatomically successful intubations (3 having had to be abandoned because of difficulties in retrieving the silicone tubes from the nose). Twenty patients (80%) had complete resolution of symptoms, 2 (8%) had improvement of symptoms such that no further intervention was necessary and 3 (12%) proceeded to DCR. A greater likelihood of a good outcome was seen if the tubes were left in situ for 6 months or more. We suggest that primary nasolacrimal intubation (that is nasolacrimal intubation without DCR) should be the next step in the management of childhood epiphora which fails to resolve after two probings. This approach may avoid a DCR in over 80% of children.

Lacrimal Intubation with the Ritleng System in Recurrent Congenital Nasolacrimal Duct Obstruction in Children

“…In congenital nasolacrimal duct obstruction, the duration the silicone stent remains in the passage varies between 6 weeks and 6 months in the published reports [2,4,7,8,19]. In our study, because the average age was relatively high, we planned to leave the tube in for 6 months.…”

Nasolacrimal duct intubation in the treatment of congenital nasolacrimal duct obstruction in older children

“…[7][8][9][10][11] On the other hand, the studies including children older than 7 years are very rare, and those studies had study population with wide age ranges also including younger children. 12,13 To the best of our knowledge, there is no study evaluating the success rates of nasolacrimal duct intubation for the treatment of CNLDO in only children older than 7 years of age. Therefore, in the current study, we aimed to investigate the outcomes of primary nasolacrimal duct intubation in the treatment of CNLDO in children older than 7 years.…”

Pediatric endocanalicular diode laser dacryocystorhinostomy: results of a minimally invasive surgical technique

“…The question of the optimum duration for the tubes remaining in situ needs an answer. Aggarwal et al [30] recommended that the tubes remain in place for 6 months. However, Marr et al [27] have suggested that this was unnecessarily long and their practice was to remove the tubes after 6 weeks.…”