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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Primary endoscopic dacryocystorhinostomy in children -- analysis of 18 patients
Ashok K Gupta1, Sandeep Bansal
1Department of Otolaryngology, Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
Insights
Endoscopic endonasal dacryocystorhinostomy (DCR) is a successful primary surgery for children with nasolacrimal duct blockage. This technique offers high success rates without stenting, comparable to external DCR in adults.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Nasolacrimal duct obstruction (NLDO) is a common condition in children.
- Traditional external dacryocystorhinostomy (DCR) can be effective but may lead to scarring and complications.
Purpose of the Study:
- To evaluate the technique and outcomes of primary endonasal endoscopic dacryocystorhinostomy (DCR) in pediatric patients with NLDO.
- To compare the results with those reported for adult DCR procedures.
Main Methods:
- A prospective study included 18 pediatric patients diagnosed with isolated NLDO.
- All patients underwent a primary endonasal endoscopic DCR procedure without stenting.
Main Results:
- The study included 18 children (5 males, 13 females), with a peak incidence in the 4-7 year age group.
- Seventeen patients (94.4%) achieved successful outcomes, confirmed by symptom relief and patent stoma visualization.
- The average follow-up period was 8.2 months (range: 6-19 months).
Conclusions:
- Endonasal endoscopic DCR without stenting demonstrates high success rates in primary pediatric surgery for NLDO.
- This minimally invasive approach offers advantages over external DCR, including shorter operative time, reduced morbidity, and avoidance of stent-related issues.
Objective:
To describe the technique and results of primary endonasal endoscopic dacryocystorhinostomy in children with nasolacrimal duct blockage and review of literature with comparison of the results in adults.
Materials And Methods:
A prospective study was carried out between the months of January 2002 to December 2004, which included 18 patients. Patients diagnosed as having only nasolacrimal duct obstruction were included in this study and an endonasal endoscopic procedure was performed.
Results:
Eighteen children underwent endoscopic the DCR procedure. There were 5 males (27.7%) and 13 females (72.3%) with the maximum incidence between the age group of 4-7 years (age ranging from 10 months to 11.2 years). The follow up period ranged from 6 to 19 months average being 8.2 months. Relief of symptoms and endoscopic visualization of the patent stoma made into the lacrimal sac with sac syringing determined a successful outcome. Seventeen patients (94.4%) fulfilled the criteria.
Conclusion:
Our experience suggests that endonasal endoscopic DCR without stenting offers the same success rates for primary surgery over external DCR as have been established in adults. Moreover, it has an added advantage of shorter operative time, less morbidity and avoidance of stent related complications.
