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Endonasal endoscopic dacryocystorhinostomy in a four-month-old infant
R Mladina1, N Stiglmayer, K Dawidowsky
1ORL Department, University Hospital Salata, Zagreb, Croatia. prof_mladina@doctor.com
Insights
Endonasal endoscopic dacryocystorhinostomy successfully treated a 4-month-old infant with severe epiphora and recurrent abscesses. This minimally invasive approach resolved the condition without silicone stent use, offering a positive outcome.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Congenital nasolacrimal duct obstruction can lead to epiphora, medial canthal swelling, and recurrent infections.
- Conservative management and external surgical approaches often fail in complex pediatric cases.
Observation:
- A 4-month-old infant presented with severe epiphora, medial canthal bulging, and recurrent abscesses of the left lacrimal sac.
- Previous conservative treatments and external incisions were unsuccessful in resolving the condition.
Findings:
- Endonasal endoscopic dacryocystorhinostomy was performed using otologic microsurgical instruments.
- The procedure was completed without the use of a silicone stent.
- At 10 months post-surgery, the infant showed significant clinical improvement.
Implications:
- Endoscopic dacryocystorhinostomy is a viable and effective treatment for complex congenital nasolacrimal duct obstruction in infants.
- Minimally invasive endoscopic techniques may obviate the need for silicone intubation in pediatric dacryocystorhinostomy.
- This approach offers a promising alternative for challenging cases refractory to conventional treatments.
Abstract:
The authors present a case of endonasal endoscopic dacryocystorhinostomy in a 4-month-old girl suffering from remarkable epiphora, persistent bulging and recurrent abscesses in the medial canthal region of the left eye. All conservative therapeutic attempts failed. Several external incisions were performed in order to solve the acute phases of the inflamed lacrimal sac. The procedure was performed by means of otologic microsurgical instruments under endoscopic control. No silicone stent was used. Ten months after surgery, the girl is doing very well.