Intranasal Endoscopic Diagnosis and Treatment in Congenital Nasolacrimal Duct Obstruction

Abstract

* BACKGROUND AND OBJECTIVE: To identify the causes of congenital nasolacrimal duct obstruction using intranasal endoscopy. * PATIENTS AND METHODS: Eleven children with symptoms of epiphora since birth were selected for treatment. A silicone tube was inserted after identifying the causes of prior probing failures by observing the probing tip directly with intranasal endoscopy. * RESULTS: As confirmed through intranasal endoscopic examination, tearing was caused by mucosal obstruction, submucosal passing of the probe, pus collection, and inferior turbinate impaction. The probe passed into the submucosal space in 5 patients and, by performing probing medially instead in the usual posterolateral direction, probing succeeded in 4 patients. One case was accompanied by a bone abnormality; we bent the probe tip into the nasal cavity to form the lacrimal pathway. * CONCLUSION: By using intranasal endoscopy, a silicone tube can be inserted under direct visualization and any causative abnormalities can be identified. This can also minimize the intranasal trauma sometimes caused by blind probing. [Ophthalmic Surg Lasers 2002;33:288-292]

Success Rate Comparison of Nasolacrimal Duct Probing with and without Assistance of Nasal Endoscope in Congenital Nasolacrimal Duct Obstruction

“…Even bony obstruction variants of NLDO can be managed successfully with nasal endoscope. 24 Further studies need to be conducted wherein the success rate of probing with the use of the nasal endoscope in failed/second attempt cases must be determined. To conclude, using a nasal endoscope is justified in every case of congenital nasolacrimal duct obstruction during probing, whether it is a primary procedure or in failed cases, irrespective of any age.…”