Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T11:41:14.069Z Has data issue: false hasContentIssue false

Success rates of endoscopic-assisted probing for congenital nasolacrimal duct obstruction in children

Published online by Cambridge University Press:  27 June 2013

S Theodoropoulou
Affiliation:
Department of Ophthalmology, Queen Margaret Hospital, NHS Fife, Dunfermline, Scotland, UK
M S M Sutherland
Affiliation:
Department of Ophthalmology, Queen Margaret Hospital, NHS Fife, Dunfermline, Scotland, UK
K Haddow
Affiliation:
ENT Department, Victoria Hospital, NHS Fife, Kirkcaldy, Scotland, UK
A Blaikie*
Affiliation:
Department of Ophthalmology, Queen Margaret Hospital, NHS Fife, Dunfermline, Scotland, UK
*
Address for correspondence: Dr A Blaikie, Department of Ophthalmology, Queen Margaret Hospital, Dunfermline KY12 0SU, Scotland, UK Fax: 01383 674089 E-mail: andrew.blaikie@nhs.net

Abstract

Objective:

To determine the success rate of initial probing in children with congenital nasolacrimal duct obstruction at different ages, using nasal endoscopy.

Methods:

Fifty eyes of 38 consecutive children with congenital nasolacrimal duct obstruction underwent endoscopic nasolacrimal duct probing under general anaesthesia. Patients were followed up for at least three months. Probing success was defined as complete remission of symptoms and a normal fluorescein dye disappearance test result.

Results:

The age range of patients was 17–109 months. The success rates of probing were: 100 per cent (29 out of 29) for cases of stenosis at the lower nasolacrimal duct, 100 per cent (7 out of 7) for functional epiphora cases and 92.86 per cent (13 out of 14) for nasolacrimal atresia cases. Overall, there was only one child for whom the probing treatment for nasolacrimal duct obstruction was not successful; this child had Down's syndrome and a more complex developmental abnormality of the nasolacrimal duct. Age and site of obstruction were not found to significantly affect the outcome of probing.

Conclusion:

Probing of the nasolacrimal system using an endoscopic approach allows direct visualisation of the nasolacrimal duct. This can facilitate diagnosis of the anomaly and significantly increase the procedure success rate.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Wallace, EJ, Cox, A, White, P, MacEwen, CJ. Endoscopic-assisted probing for congenital nasolacrimal duct obstruction. Eye (Lond) 2006;20:9981003CrossRefGoogle ScholarPubMed
2MacEwen, CJ, Young, JDH, Barras, CW, Ram, B, White, PS. Value of nasal endoscopy and probing in the diagnosis and management of children with congenital epiphora. Br J Ophthalmol 2001;85:314–18CrossRefGoogle ScholarPubMed
3MacEwen, CJ, Young, JD. Epiphora during the first year of life. Eye (Lond) 1991;5:596600CrossRefGoogle ScholarPubMed
4MacEwen, CJ. Congenital nasolacrimal duct obstruction. Compr Ophthalmol Update 2006;7:7987Google ScholarPubMed
5Ram, B, Barras, CW, White, PS, MacEwen, CJ, Young, JDH. The technique of nasendoscopy in the evaluation of nasolacrimal duct obstruction in children. Rhinology 2000;38:83–6Google ScholarPubMed
6Hanovar, SG, Prakash, VE, Rao, GN. Outcome of probing for congenital nasolacrimal duct obstruction in older children. Am J Ophthalmol 2000;130:42–8CrossRefGoogle Scholar
7Katowitz, JA, Welsh, MG. Timing of initial probing and irrigation in congenital nasolacrimal duct obstruction. Ophthalmology 1987;94:698705CrossRefGoogle ScholarPubMed
8Robb, RM. Success rates of nasolacrimal duct probing at time intervals after 1 year of age. Ophthalmology 1998;105:1307–10CrossRefGoogle ScholarPubMed
9El-Mansoury, J, Calhoun, JH, Nelson, L, Harley, RD. Results of late probing for congenital nasolacrimal duct obstruction. Ophthalmology 1986;93:1052–4CrossRefGoogle ScholarPubMed
10Gardiner, JA, Forte, V, Pashby, RC, Levin, AV. The role of nasal endoscopy in repeat pediatric nasolacrimal duct probings. J AAPOS 2001;5:148–52CrossRefGoogle ScholarPubMed
11Kashkouli, MB, Beigi, B, Parvaresh, MM, Kassaee, A, Tabatabaee, Z. Late and very late initial probing for congenital nasolacrimal duct obstruction: what is the cause of failure? Br J Ophthalmol 2003;87:1151–3CrossRefGoogle ScholarPubMed
12Zilelioglu, G, Hosal, B. The results of late probing in congenital nasolacrimal duct obstruction. Orbit 2007;26:13CrossRefGoogle ScholarPubMed
13Cassady, JV. Developmental anatomy of the naso-lacrimal duct. Arch Ophthalmol 1952;47:141–58CrossRefGoogle Scholar
14Paul, TO. Medical management of congenital nasolacrimal duct obstruction. J Pediatr Ophthalmol Strabismus 1985;22:6870CrossRefGoogle ScholarPubMed
15Nelson, LB, Calhoun, JH, Menduke, H. Medical management of congenital nasolacrimal duct obstruction. Ophthalmology 1985;92:1187–90CrossRefGoogle ScholarPubMed
16Mannor, GE, Rose, GE, Frimpong-Ansah, K, Ezra, E. Factors affecting the success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction. Am J Ophthalmol 1999;127:616–17CrossRefGoogle ScholarPubMed
17Kouri, AS, Tsakanikos, M, Linardos, E, Nikolaidou, G, Psarommatis, I. Results of endoscopic assisted probing for congenital nasolacrimal duct obstruction in older children. Int J Pediatr Otorhinolaryngol 2008;72:891–6CrossRefGoogle ScholarPubMed
18Sener, EC, Onerci, M. Reappraisal of probing of the congenital obstruction of the nasolacrimal system: is nasendoscopy essential? Int J Pediatr Otorhinolarnygol 2001;58:65–8CrossRefGoogle Scholar
19Arora, S, Koushan, K, Harvey, JT. Success rates of primary probing for congenital nasolacrimal obstruction in children. J AAPOS 2012;16:173–6CrossRefGoogle ScholarPubMed
20Coats, DK, McCreery, KMB, Plager, DA, Bohra, L, Kim, DS, Paysse, EA. Nasolacrimal outflow drainage anomalies in Down's syndrome. Ophthalmology 2003;110:1437–41CrossRefGoogle ScholarPubMed