Conjunctivocystorhinostomy with Jones tube—is it the surgery for children?

Abstract

CDCR appears to be a reasonable procedure in children over 10 years old. Experience in lacrimal surgery (pediatric dacryocystorhinostomy, CDCR in adults), and good cooperation and compliance of children are a fundamental assumption for successful pediatric CDCR.

Botulinum Toxin Injection Into the Lacrimal Gland for Treatment of Proximal Nasolacrimal Duct Obstructions in Children

“…However, this procedure is rarely performed in children because of the difficulties encountered. 7 Good patient cooperation and compliance with the Jones tube are absolutely essential for surgical success. Complication rates of conjunctival dacryocystorhinostomy in children are significantly higher than in adults, with tube malposition and extrusion seen commonly.…”

“…Complication rates of conjunctival dacryocystorhinostomy in children are significantly higher than in adults, with tube malposition and extrusion seen commonly. 7 Because of the success noted in adults who received botulinum toxin injections in the lacrimal gland for treatment of epiphora, this method of treatment was offered to children with proximal lacrimal drainage obstruction. The results reported herein demonstrate similar results in children as in adults.…”

Conjunctivodacryocystorhinostomy (CDCR) success rates and complications in endoscopic vs non‐endoscopic approaches: a systematic review

“…The mean follow-up was specified in 41 studies. 2,[10][11][12][13][14][17][18][19][20][21]23,[25][26][27][28][29][30][32][33][34][38][39][40][41][42][43][44][45][46][47][48][49]51,54,[57][58][59][60][61] Mean follow-up of all included patients was 24 ± 17.6 months. In 12 studies only range or median of follow-up duration was reported.…”

“…The etiology of canalicular obstruction was reported in 44 studies, 2,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][30][31][32][33][34][35][36]38,39,[41][42][43][45][46][47][48][49][50][51][53][54][55]57,58 in which a total of 1845 patients were included. The distribution of patients according to etiology was as follows: trauma (25.5%); congenital (16.7%); cancer-related (secondary to surgery); radiation or chemotherapy (7.5%); idiopathic (6.5%); and defined as failed DCR (9.1%).…”

“…26,27 Other studies used other types of tubes: Putterman-Gladstone tube in 6 studies 11,17,23,28,41,45 ; silicone or polythene tubes in 6 studies 30,35,38,47,50,52 ; 3 studies used mucus membrane techniques. 32,49,54 Endoscopy-assisted approach Twenty-one (39%) studies 5,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] reported using a nasal endoscope or a combination of a non-endoscopy-assisted and endoscopy-assisted approach during the procedure. All these studies used Pyrex tubes and were published from 2000 onward.…”