Paediatric powered endonasal dacryocystorhinostomy.

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Pediatric Surgery

Background:

• Persistent nasolacrimal duct obstruction (NLDO) is a common condition in children requiring surgical intervention.
• Dacryocystorhinostomy (DCR) is the standard surgical treatment for NLDO.
• Endoscopic endonasal DCR offers a minimally invasive alternative to external DCR.

Purpose of the Study:

• To evaluate the outcomes of pediatric patients undergoing endonasal endoscopic DCR.
• To assess the safety and efficacy of this procedure in a district general hospital setting.
• To identify factors influencing treatment success.

Main Methods:

• Retrospective review of pediatric patients (ages 2-14) undergoing endonasal endoscopic DCR.
• Data collected from October 2001 to December 2008.
• Main outcome measure was symptom resolution (epiphora, discharge).

Main Results:

• Sixteen children (17 eyes) were analyzed.
• 82% presented with epiphora; 3 had Down syndrome.
• No operative complications were reported.
• 12-month follow-up showed symptom improvement in all but one case.
• 60% achieved complete symptom resolution; others were minimally symptomatic.
• Residual symptoms were noted in two patients with Down syndrome.

Conclusions:

• Endonasal endoscopic DCR is a safe and effective treatment for pediatric NLDO.
• Success rates are higher in children without craniofacial abnormalities.
• Multidisciplinary care involving Oculoplastic and ENT surgeons optimizes patient outcomes.