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Updated: May 9, 2026
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 18, 2011
Repositioning of the completely prolapsed lacrimal tube after bicanalicular intubation: a novel technique
Ahmed N Kotb1, Sahar Hemeda1, Sherif Sharaf El Deen1
1Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Insights
A new technique successfully repositions prolapsed lacrimal tubes in children with congenital nasolacrimal duct obstruction. This safe and effective method avoids repeat surgeries, offering a cost-effective solution for tube prolapse management.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Oculoplastics
Background:
- Congenital nasolacrimal duct obstruction (CNLDO) is common in infants.
- Bicanalicular intubation is a standard treatment for CNLDO.
- Complete lacrimal tube prolapse can necessitate revision surgery.
Purpose of the Study:
- To evaluate the outcomes of a novel technique for repositioning completely prolapsed lacrimal tubes.
- To assess the safety and efficacy of this technique in pediatric patients.
Main Methods:
- Retrospective review of 18 children with complete lacrimal tube prolapse.
- Analysis of demographic data, intubation details, and time to prolapse.
- Documentation of the repositioning procedure, complications, and success rates.
Main Results:
- The novel repositioning technique achieved an 83.3% success rate in 18 eyes.
- Mean procedure duration was 11.8 minutes; mild nasal bleeding occurred in 13.3%.
- Recurrent partial prolapse was observed in 13.3% of cases postoperatively.
Conclusions:
- The novel repositioning technique is safe and effective for complete lacrimal tube prolapse post-intubation.
- This method salvages the existing tube, reducing costs and patient burden.
- The technique offers a viable alternative to repeat intubation procedures.
Purpose:
To evaluate the outcomes of a novel technique for repositioning a completely prolapsed lacrimal tube after bicanalicular intubation for congenital nasolacrimal duct obstruction.
Methods:
This retrospective study included 18 children with complete lacrimal tube prolapse that could not be repositioned from the nose during the period from July 2020 to August 2023. Medical records were reviewed for demographic data, date and details of the initial intubation surgery, and the time till tube prolapse was calculated. Description of the repositioning procedure including the duration, intraoperative complications and success rate were reported. Postoperative follow-up visits were scheduled weekly for 1 month then monthly till tube removal to record tube stability and any postoperative complications. After tube removal, follow up was continued for 3 months to detect recurrent epiphora.
Results:
18 eyes of 18 children were included with a mean age of 1.36 ± 0.24 years. Mean time till tube prolapse was 23.6 ± 17.1 days. The success rate of the novel repositioning technique was 83.3%. The mean duration of the procedure was 11.8 ± 1.8 min. 2 (13.3%) cases had mild intraoperative nasal bleeding that did not prevent repositioning. No other intraoperative complications were reported. Postoperatively, 2 (13.3%) children showed recurrent partial tube prolapse.
Conclusion:
The novel repositioning technique is safe and effective in children with complete tube prolapse after bicanalicular intubation. It salvages the existing tube avoiding the added cost and burden of a new intubation. Trial registration ZU-IRB#11052-13-9-2023, 13/9/2023 'retrospectively registered'.
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