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Limited Approach in Endoscopic Dacryocystorhinostomy of Pediatrics

Seyyed Mostafa Hashemi1, Afrooz Eshaghian2

  • 1Department of Otorhinolaryngology, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Advanced Biomedical Research
|December 28, 2017
PubMed

Insights

A limited endoscopic approach for pediatric dacryocystorhinostomy (DCR) offers acceptable outcomes in uncomplicated cases. This technique provides minimal manipulation and increased confidence for young patients undergoing DCR surgery.

Area of Science:

  • Ophthalmology
  • Otorhinolaryngology
  • Pediatric Surgery

Background:

  • Pediatric dacryocystorhinostomy (DCR) presents surgical challenges due to the narrow nasal cavity in children.
  • A limited endoscopic approach was evaluated for pediatric DCR to address these difficulties.

Purpose of the Study:

  • To assess the efficacy and outcomes of a limited endoscopic approach for pediatric dacryocystorhinostomy.
  • To evaluate the consequences and success rates of this modified surgical technique in young patients.

Main Methods:

  • An experimental study involving pediatric patients (<14 years) undergoing a limited endoscopic DCR.
  • The procedure involved endoscopic exposure and extrusion of lacrimal bone, marsupialization, and lacrimal sac exposure via a bone defect, followed by silicone tube intubation.

Main Results:

  • 16 pediatric DCR procedures were performed between 2006 and 2012.
  • Pre-operative symptoms included epiphora (87.5%) and eye discharge (18.8%). Congenital nasolacrimal duct insufficiency was present in 62.5% of cases.
  • Post-operatively, 3 patients (18.8%) showed complete improvement, 2 (12.5%) had very good improvement, and 2 (12.5%) required revision surgery.

Conclusions:

  • The limited endoscopic approach for pediatric DCR is feasible in non-complicated cases.
  • This technique offers minimal manipulation, increased patient and parent confidence, and acceptable surgical results.
Abstract

Keywords:
Dacryocystorhinostomyendoscopymethods

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