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Updated: Jun 14, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Primary pediatric endonasal dacryocystorhinostomy--a review of 58 procedures
Pavel Komínek1, Stanislav Cervenka, Petr Matousek
1Department of Otorhinolaryngology, University Hospital Ostrava, 17 listopadu Street 1790, 708 52 Ostrava, Czech Republic. pavel.kominek@fno.cz
Insights
Endoscopic dacryocystorhinostomy (EDCR) is a safe and effective treatment for pediatric lacrimal system obstruction. This study found an overall success rate of 87.9% in children, with higher success for postsaccal obstructions.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Lacrimal system obstruction is a common condition in children.
- Endoscopic dacryocystorhinostomy (EDCR) is a minimally invasive surgical approach.
Purpose of the Study:
- To evaluate the outcomes of primary endoscopic dacryocystorhinostomy (EDCR) in pediatric patients.
- To determine the success rate and influencing factors of EDCR in children.
Main Methods:
- Retrospective case series of 58 children (3 months to 13 years) undergoing primary EDCR.
- Standardized surgical technique used by two surgeons.
- Follow-up included clinical examination and fluorescein disappearance test.
Main Results:
- Overall success rate of 87.9% (51/58) for primary EDCR.
- Higher success rates observed in postsaccal obstructions (92.2%) compared to presaccal (50%) or combined obstructions (60%).
- Excellent outcomes in younger children: 100% success in those under 1 year and 93.3% in those aged 1-2 years.
Conclusions:
- Endoscopic DCR is a safe and effective procedure for pediatric lacrimal system obstruction.
- Success rates are comparable to external DCR and adult outcomes.
- Location of obstruction significantly impacts EDCR success in children.
Objectives:
The objectives of this study are to report the outcomes of pediatric patients with lacrimal system obstruction who underwent primary endoscopic dacryocystorhinostomy (EDCR).
Study Design:
The authors conducted a retrospective noncomparative case series.
Methods:
The operative and postoperative data have been collected in 58 children aged between 3 months and 13 years (mean 4.1 years). The total of 58 primary EDCRs has been performed by two surgeons using a standardized surgical technique. The EDCRs were performed 52 times on one eye, 6 times on both eyes (3 times simultaneously, 3 times at the separate sitting with an interval of 4-6 months). The follow-up evaluations include taking history, clinical examinations including a fluorescein disappearance test.
Results:
The follow-up interval ranged from 12 to 36 months (mean 17 months, median 15 months). The success rate was 51/58 (87.9%) in all 58 EDCRs. The success rate was 47/51 (92.2%) in the group of postsaccal obstructions, 3/5 (60.0%) in the group of postsaccal and suprasaccal obstrutcions and 1/2 (50.0%) in presaccal obstructions. The procedures were successful in all eight children aged under 1 year old (100%) and in 14 of 15 children between 1 and 2 years old (93.3%). The silicone intubation was used in 54 EDCRs.
Conclusions:
The endoscopic DCR is a safe and effective procedure for most children with the success rate comparable to that achieved in the external DCR and in adults. The success rate of the postsaccal obstructions is significantly higher than in presaccal or combined pre- and postsaccal obstructions.
