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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Pediatric endonasal dacryocystorhinostomy: a report of 34 cases
Pavel Komínek1, Stanislav Cervenka
1Department of Otolaryngology, City Hospital, Frýdek-Místek, the Czech Republic. kominek@nemfm.cz
Insights
Endoscopic dacryocystorhinostomies (EDCR) in children is a safe and effective procedure for tear duct obstruction. Success rates for primary EDCRs are high, with revisions also showing good outcomes.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital nasolacrimal duct obstruction is common in infants.
- Endoscopic dacryocystorhinostomy (EDCR) offers a minimally invasive approach for treating pediatric nasolacrimal duct obstruction.
Purpose of the Study:
- To evaluate the safety and efficacy of endoscopic dacryocystorhinostomy (EDCR) in pediatric patients.
- To present surgical outcomes and success rates of EDCR in children.
Main Methods:
- A case series of 34 pediatric endoscopic dacryocystorhinostomies (EDCR) was analyzed.
- Procedures were performed by a single surgeon using a standardized technique.
- Follow-up included symptom evaluation and endoscopic assessment with fluorescein testing.
Main Results:
- Primary EDCR success rate was 82.3% (28/34) at 12-36 months follow-up.
- Success varied by obstruction type: 88.9% for subsaccal, 60.0% for combined, and 50.0% for suprasaccal.
- Revision EDCRs were successful in 5 out of 6 cases.
Conclusions:
- Endoscopic dacryocystorhinostomy (EDCR) is a safe and successful surgical option for pediatric patients with nasolacrimal duct obstruction.
- Success rates are comparable to external dacryocystorhinostomy and adult EDCR outcomes.
Objectives:
To present experience with the endoscopic dacryocystorhinostomies (EDCR) at the pediatric age.
Study Design:
Case series, clinical study.
Methods:
The operative and postoperative data have been collected in 34 pediatric EDCRs (mean age 4.5 years; range 4 months to 13 years). The total of 34 primary and 5 revision procedures have been performed by the same surgeon using a standardized surgical technique. The follow-up evaluations include symptom evaluations and the endoscopic assessment of the newly created ostium with fluorescein testing.
Results:
The 28 of 34 primary EDCRs (82.3%) were patent after a mean follow-up of 12 to 36 months: 24 of 27 (88.9%) procedures with subsaccal obstructions, 3 of 5 (60.0%) with combined subsaccal and suprasaccal obstructions, and 1 of 2 (50.0%) with suprasaccal obstructions. Intubation was used in 30 primary EDCRs. We found no differences in the success rate between the group with operative intranasal debridement and the group without it in the follow-up period. EDCRs failed in six patients, five of whom were revised endoscopically with success.
Conclusions:
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.
