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Updated: Jun 2, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Paediatric powered endonasal dacryocystorhinostomy
Dania Al-Nuaimi1, Clare Inkster, Christopher Lobo
1Department of Ophthalmology, Royal Bolton Hospital NHS Foundation Trust, Minerva Road, Farnworth, Bolton, UK. dania1979@doctors.org.uk
Insights
Endoscopic endonasal dacryocystorhinostomy (DCR) effectively treats persistent nasolacrimal duct obstruction (NLDO) in children. This minimally invasive procedure offers high success rates, improving symptoms in most pediatric patients.
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.
Abstract:
Dacryocystorhinostomy (DCR) is indicated in children with persistent nasolacrimal duct obstruction (NLDO). Endoscopic endonasal DCR has been successfully performed in both adults and children, with success rates similar to that of external DCR. This paper aims to evaluate the outcomes of paediatric patients undergoing endonasal endoscopic DCR at a district general hospital. A retrospective review of all patients attending a joint lacrimal clinic undergoing endonasal endoscopic DCR between October 2001 and December 2008 was performed. Sixteen children (17 eyes) aged between 2 and 14 were analysed. The main outcome measure was resolution of symptoms. Fourteen cases (82%) presented with epiphora with or without stickiness. Three cases had recurrent dacryocystitis. Three patients had Down syndrome. There were no operative complications. During a mean post-operative period of 12 months, all but one case showed an improvement of symptoms. While 60% of the patients had a complete resolution of symptoms, the remaining were minimally symptomatic. Of those with residual symptoms, two had Down syndrome. Endonasal DCR is a safe and effective intervention for children with persistent NLDO. Success is higher in children with no craniofacial abnormality. Joint care under a consultant Oculoplastic and ENT surgeon provides optimum care for these patients.
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