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Pediatric endonasal dacryocystorhinostomy and operative standardization

D-T Nguyen1, B Fayet1, E Racy2

  • 1Service d'ophtalmologie, hôpital universitaire, Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Université Paris V René Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France.

Journal Francais D'Ophtalmologie
|March 26, 2019
PubMed

Insights

Standardized endonasal dacryocystorhinostomy (DCR) surgery is effective in children, yielding success rates similar to adults. This technique adapts well to pediatric nasal cavities, with minimal complications observed.

Area of Science:

  • Otolaryngology
  • Ophthalmology
  • Pediatric Surgery

Background:

  • Endonasal dacryocystorhinostomy (DCR) is a standard surgical procedure for adults with nasolacrimal duct obstruction.
  • Adaptation of adult surgical techniques to pediatric populations requires careful consideration of anatomical differences.

Purpose of the Study:

  • To evaluate the efficacy and safety of a standardized endonasal dacryocystorhinostomy (DCR) technique in pediatric patients.
  • To compare surgical outcomes in children versus adults undergoing the same DCR procedure.

Main Methods:

  • A consecutive series of pediatric patients undergoing endonasal DCR between 2003 and 2017 were analyzed.
  • The standardized technique involved preoperative CT scans, mucoperiosteal flap creation, and osteotomy.
  • Pediatric results were compared to a control group of adult patients operated using the identical technique.

Main Results:

  • Twenty DCR procedures were performed on 17 pediatric patients (mean age 8 years).
  • Successful anatomical localization was achieved in 100% of cases.
  • The overall success rate was 95% with a mean follow-up of 4 years, and no major complications were reported. Outcomes were comparable to adult patients.

Conclusions:

  • The standardized endonasal DCR technique is adaptable to the pediatric nasal anatomy.
  • Physiological narrowness of the pediatric nasal cavity is manageable with appropriately sized instruments.
  • Endoscopic endonasal DCR offers similar high success rates and complication profiles in both pediatric and adult populations.
Abstract

Keywords:
DacryocystorhinostomieDacryocystorhinostomyImperforation lacrymo-nasaleLacrimal duct obstructionNasolacrimal duct obstructionObstruction des voies lacrymalesPediatricsPédiatrieUnciformectomieUnciformectomyUncinectomy

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