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Pediatric nasolacrimal duct obstruction-benefit of a combined therapeutic approach

Miloš Fischer1,2, Iris-Susanne Horn3, Mathias Otto4

  • 1Clinic of Otolaryngology, Head and Neck Surgery and Department of Head Medicine and Oral Health, University Hospital Leipzig, Leipzig, Germany. milos.fischer@sbk-vs.de.

World Journal of Pediatrics : WJP
|May 26, 2017
PubMed

Insights

Pediatric nasolacrimal duct obstruction (PNDO) treatment outcomes improved with an endonasal endoscopic approach compared to conventional probing. This technique offers better stenosis identification and surgical intervention for improved clinical results in children.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Otorhinolaryngology

Background:

  • Pediatric nasolacrimal duct obstruction (PNDO) often necessitates intervention when conservative methods fail.
  • A lack of standardized treatment guidelines for PNDO highlights the need for comparative studies.

Purpose of the Study:

  • To evaluate and compare the effectiveness of two distinct intervention techniques for pediatric nasolacrimal duct obstruction.
  • To determine the advantages of conventional probing versus an endonasal endoscopic approach in pediatric PNDO management.

Main Methods:

  • A cohort of 233 children (aged 0-208 months) with PNDO were treated between January 2006 and June 2014.
  • Group I underwent conventional probing by ophthalmologists; Group II received an endonasal endoscopic interdisciplinary approach.
  • Clinical outcomes were analyzed to assess treatment efficacy.

Main Results:

  • The endonasal endoscopic approach (Group II) demonstrated a higher overall success rate (98.4%) compared to conventional probing (Group I, 93.4%).
  • Approximately 50% of Group II interventions required additional surgical procedures, particularly in younger (<6 months) and older (>24 months) children.

Conclusions:

  • Endoscopic control facilitates precise identification of nasolacrimal duct stenosis, enabling targeted surgical intervention and improved clinical outcomes.
  • Endonasal endoscopic surgical techniques are recommended as the standard of care for treating pediatric nasolacrimal duct obstruction.
Abstract

Keywords:
Hasner valvedacryocystocelenasal endoscopynasolacrimal duct probingpediatric nasolacrimal duct obstruction

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