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Abstract ID: 24-126
Successful endonasal dacryocystorhinostomy implementation in early childhood
Ekaterina Kondratishko
Purpose
Nasolacrimal duct obstruction (NLDO) is a prevalent cause of epiphora and chronic dacryocystitis in both adults and children. Endonasal dacryocystorhinostomy (endoDCR) has emerged as an effective treatment option for NLDO, including congenital cases. This study aimed to evaluate the efficacy of endoDCR in paediatric patients.
Methods
Conducted at a single institution by a consistent surgical team from 2016 to 2023, the study focused on children over 32 months old with previously diagnosed congenital NLDO, unresponsive to prior minimally invasive and conservative treatments. Preoperatively, CT dacryocystography was performed under general anaesthesia. Adenoidectomy was also performed during surgery to reduce the risk of secondary infection and improve nasal breathing. All procedures utilized minimal instrument sizes and silicone stents, with stent removal under general anaesthesia.
Results
Four children, undergoing surgery on a total of five eyes, were included in the study, aged between 33 months and 6 years. All patients underwent a single-step operation, with surgery durations ranging from 40 minutes to 2 hours. Four eyes were stented with silicone tubes according to standard practice, with stent removal within one to two months. During the six-month follow-up period, five eyes showed successful treatment outcomes, with no recurrence of epiphora or signs of inflammation. Polyps were detected in two cases, one during stent evacuation and promptly removed, and the other found during a subsequent operation and successfully treated.
Conclusion
EndoDCR appears to be a safe and effective method for treating congenital NLDO in children. However, the invasive nature of the procedure and the need for general anaesthesia raise concerns. Despite the widespread use of stenting, its overall efficacy remains debated. Further research and exploration of alternative approaches are warranted to optimize outcomes and minimize risks in paediatric patients with NLDO.
Additional Authors
Anna Kremneva – Riga Stradiņš University
Irina Kornilova – Riga Stradiņš University
Aleksejs Derovs – Riga Stradiņš University
Ģirts Briģis – Riga Stradiņš University