A Survey of Management of Congenital Nasolacrimal Duct Obstruction by Pediatric Primary Health Care Providers in Spain

Galindo‐Ferreiro, Alicia; Palencia-Ercilla, Teresa; Ferreira, Livia Mendoza; Galvez-Ruiz, Alberto; Zornoff, Denise C M; Khandekar, Rajiv; Schellini, Silvana Artioli

doi:10.5301/ejo.5000915

Cited by 2 publications

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“…congenital nasolacrimal duct obstruction (cnldo) is a common developmental anomaly and a cause of visits in pediatric primary care. it results from a failure of canalization of the nasolacrimal duct, and affects up to 20% of normal newborns [1][2][3][4]. the diagnosis is made in a vast majority of cases (approximately 90%) by a primary care physician, at a median age of 5 weeks without gender predilection.…”

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confidence: 99%

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Rhinoscopy assisted lacrimal probing – minimal invasive and effective therapeutic option for children with congenital nasolacrimal duct obstruction

Magdalena¹,

Pucher²,

Kałużna-Młynarczyk³

et al. 2018

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Background. congenital nasolacrimal duct obstruction (cnldo) is a common developmental anomaly, and in most cases, obstruction is located at the distal end of the nasolacrimal duct. the rate of spontaneous resolution of cnldo is up to 96% during the first year of life, and, therefore, most authors advise only medical treatment in the first months of life. when obstruction persists, lacrimal probing is performed. conventionally, the next steps in surgical treatment are lacrimal intubation and dacryocystorhinostomy. the intranasal approach was first proposed many years ago, but became possible only after the development of advanced endoscopic rhinosurgery. at present, it is widely used to treat cnldo. Objectives. to evaluate the effectiveness of rhinoscopy assisted lacrimal probing as a treatment for congenital nasolacrimal duct obstruction in children. Material and methods. we enrolled 14 children with cnldo to this case series study. all children underwent surgery between 01.03.2016 and 30.03.2018. data about symptoms and previous treatment were first collected, surgery was then performed, and all patients were then reexamined postoperatively and data about results recorded. Results. the age range was 6-152 months (median 30 months). Four (4) patients had no history of previous surgery, and ten (10) had undergone lacrimal probing before. the overall final success rate was 85.71% (12/14 patients, including 2 infants with dacryocystitis). Conclusions. in our group of patients, endoscopy assisted lacrimal probing is an effective method of treatment for cnldo. we suggest to use this method in cases of children older than 12 months with one or more unsuccessful probing, with infants with dacryocystitis, and always before considering dacryocystorhinostomy.

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Section: Introductionmentioning

confidence: 99%

“…Massaging the nasolacrimal sac in a downward direction creates hydrostatic pressure which can rupture the membranous obstruction. antibiotic drops ameliorate inflammatory symptoms while waiting for resolution [1,2,5].…”

Section: Introductionmentioning

confidence: 99%

Rhinoscopy assisted lacrimal probing – minimal invasive and effective therapeutic option for children with congenital nasolacrimal duct obstruction

Magdalena¹,

Pucher²,

Kałużna-Młynarczyk³

et al. 2018

fmpcr

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Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared with observation alone

2021

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Background/aimsTo determine if nasolacrimal massage or topical antibiotics are associated with higher rates of resolution compared with observation alone in a population-based cohort of infants with congenital nasolacrimal duct obstruction (CNLDO).MethodsThe medical records of all children <5 years diagnosed with CNLDO while residing in Olmsted County, Minnesota from 1 January 1995 through 31 December 2004 were retrospectively reviewed for type of management and non-surgical resolution of tearing.ResultsAmong 1958 infants diagnosed and followed for CNLDO, 516 (26.4%) were merely observed, 506 (25.8%) were prescribed massage alone, 485 (24.8%) were prescribed at least one course of topical antibiotics, 397 (20.3%) were prescribed both topical antibiotics and massage, and 54 (2.8%) had no documented therapy. Non-surgical resolution, occurring in 1669 (85.2%) during a median follow-up of 3.1 months (range: 1 week–248 months), was 74.6% for the merely observed, 89.7% for those prescribed digital massage, 87.0% for those prescribed antibiotics and 90.7% for those treated with both. This comparison was significant in unadjusted (p<0.001) and multivariable comparisons (p<0.001).ConclusionPrescribing topical antibiotics or digital massage for infants with CNLDO in this cohort, individually or in combination, was associated with a higher rate of spontaneous resolution than observation alone.

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A Survey of Management of Congenital Nasolacrimal Duct Obstruction by Pediatric Primary Health Care Providers in Spain

Abstract: Massage was the main initial treatment for managing CNLDO among pediatricians. The outcomes of this survey indicated that massage fails in fewer than 50% of patients and an ophthalmic referral is required for these cases.

Cited by 2 publications

References 24 publications

Rhinoscopy assisted lacrimal probing – minimal invasive and effective therapeutic option for children with congenital nasolacrimal duct obstruction

Rhinoscopy assisted lacrimal probing – minimal invasive and effective therapeutic option for children with congenital nasolacrimal duct obstruction

Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared with observation alone

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