Success of Simple Probing and Irrigation in Patients With Nasolacrimal Duct Obstruction and Otitis Media

Lee, Dave H.; Fudemberg, Scott J.; Davitt, Bradley V.; Cruz, Oscar A.

doi:10.1016/j.jaapos.2004.12.009

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…[9][10][11][12][13][14][15] The current study's success rate also compares favorably with balloon dacryocystoplasty which although it has found a high success rate for recurrent nasolacrimal duct obstruction, 5,16,17 appears to offer no significant advantage over simple probing as a primary treatment. 18,19 The timing of surgical intervention for nasolacrimal duct obstruction is controversial.…”

Section: Discussionmentioning

confidence: 90%

“…A large, prospective randomized, study would be necessary to more directly evaluate the advantages and disadvantages of silastic intubation versus simple probing in the initial treatment of congenital nasolacrimal duct obstruction obstruction. 10 110 97% 88% 92% Robb (1998) 11 280 98% from 0 to 24 mo 100% Mannor (1999) 12 142 92% 89% 69% Honavar (2000) 13 60 All patients Ն 24 mo of age 73% (median age 33 mo) Kashkowli and Kassaee (2002) 14 207 92% 85% 65% Lee and Fudenberg (2005) 15 138 Age range 4.5 to 36 mo (average, 12.4) Success rate 86%…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction

Engel¹,

Hichie-Schmidt²,

Khammar³

et al. 2007

Journal of American Association for Pediatric Ophthalmology and

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction

Engel¹,

Hichie-Schmidt²,

Khammar³

et al. 2007

Journal of American Association for Pediatric Ophthalmology and

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“…The results of probing with or without silastic intubation reported in other studies range from 55% to 96%. (18,19,20,21,22,23,24) The success rate of probing in our study was 82 %. This lower rate may be due to inclusion of some complicated cases like previously failed cases and associated with craniofacial anomalies.…”

Section: Discussionmentioning

confidence: 48%

“…Number of Eyes Success Rate of Simple Probing as per the Age 0-12 months 13-24 months >24 months Katowitz and Welsh (30) 572 97% 69% 33.3% Zwaan (31) 110 97% 88% 92% Robb (22) 280 98% from 0 to 24 months Mannor et al (27) 142 92% 89% 69% Honavar et al (20) 60 All patients>24 months age Maheswari (21) 84 88.1% 80.1% Kashkouli et al (29) 207 92% 85% 65% Repka et al (19) 955 78% 79% 79% Lee et al (24) 138 Overall success rate of 86% (average age of 12.4 months) Present study Number of eyes 12-23 months 24-35 months ≥36 months Balakrishnan et al 22 100% 100% 40% Table 5. Success rate of probing in previous studies…”

Section: Studymentioning

confidence: 99%

Management of Epiphora in Children- Prospective Analysis

Balakrishnan¹,

Mohanraj²,

Sowmiya³

et al. 2018

jemds

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BACKGROUND Lacrimation is caused by reflex over-production of tears from stimulation of the trigeminal nerve by irritation of the cornea or conjunctiva. In these cases, the excess watering is associated with symptoms of the underlying cause and treatment is usually medical. Obstructive epiphora is caused by mechanical obstruction of tear drainage. It is characterized by excessive watering which is exacerbated by a cold and windy atmosphere, and is least in a warm dry room. Most cases can be relieved by surgery. Lacrimal pump failure occurs secondary to lower lid laxity or weakness of the orbicularis muscle. Treatment is more difficult than that of obstructive epiphora. Purpose-To study success of various methods of treatment for epiphora in children below 11 years and to compare clinical profile between children below 2 years (early onset) and children above 2 years (late onset). Design-Prospective observational study. MATERIALS AND METHODSStudy was conducted in 209 eyes of 167 patients (42 bilateral cases) during five years period between Jan 2010 to Jan 2015. The success of treatment was defined as complete resolution of symptoms and negative regurgitation on pressure over lacrimal sac (ROPLAS) area; Patients were followed up for 8.4 ± 2.1 months. RESULTS87 percent (145 of 167) cases were below 2 years and 13 percent (22 of 167) were children above 2 years. The male: female ratio was 1.3:1. Seventy five percent cases were unilateral. Cause for 92% cases were congenital nasolacrimal duct obstruction (NLDO), 6% traumatic or surgical and 2% acquired NLDO. The success rate of total 209 cases were 98% (205 eyes), 89% for sac massage, 82% for probing, 64% for external dacryocystorhinostomy (DCR). Statistically significant relation was noted between the treatment result and laterality (P-0.04), symptom severity (P-0.027), previously treated cases (P-0.024) and age. All cases below 2 years with NLDO were completely cured by sac massage and few cases with probing. No significant association was found between treatment result and sex (P-0.73). CONCLUSIONProperly done sac massage alone for weeks to many months is best treatment for early onset NLDO in children less than 2 years. Probing was successful in 82% of children. Probing and DCR were required in older children. Mucoid discharge and recurrent ocular infection had decreased overall treatment success. There was significant correlation between laterality, symptom severity and previous treatment.] KEYWORDS Epiphora, Children, Observational Study, India. HOW TO CITE THIS ARTICLE: Balakrishnan M, Mohanraj K, Sowmiya KR, et al. Management of epiphora in children-prospective analysis. J. Evolution Med. Dent. Sci. 2018;7(09):1091-1095, DOI: 10.14260/jemds/2018/248 BACKGROUND Epiphora is excessive watering of eyes despite normal tear production due to any obstruction in lacrimal drainage pathway. Congenital nasolacrimal duct obstruction (CNLDO) is a common condition affecting 20% infants in their first year of life (1) and occurs due to the failure of canalization ...

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“…2-11 Questionnaires have been used infrequently, and then in only simple form, to assess NLDO outcomes. [12][13][14][15][16][17][18] We are unaware of any previous attempt to prospectively use a comprehensive questionnaire to assess severity of symptoms and health related quality of life (HRQL) in congenital NLDO.…”

Section: Introductionmentioning

confidence: 99%

A Symptom Survey and Quality of Life Questionnaire for Nasolacrimal Duct Obstruction in Children

et al. 2006

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Purpose-To develop and validate a new parental questionnaire addressing symptoms and health related quality of life (HRQL) in congenital nasolacrimal duct obstruction (NLDO).Design-Cross-sectional study. Participants-Children aged 6 to <48 months with and without clinical signs of NLDO.Methods-A new questionnaire was developed using semi-structured interviews with parents of children with NLDO and through discussions with expert clinicians. Questionnaires were completed by parents of children with NLDO and without NLDO. Cronbach's alpha was calculated as a measure of internal-consistency reliability. Factor analysis was used to evaluate a priori subscales; symptoms and HRQL. Discriminant construct validity was assessed by comparing questionnaire scores between children with and without NLDO and between affected and unaffected eyes of children with unilateral NLDO. Instrument responsiveness was determined by comparing pre-and post-surgical intervention scores in a subset of NLDO subjects who underwent surgical treatment.Main outcome measure-NLDO questionnaire score.Results-87 children were enrolled, 56 with NLDO and 31 without. All but two questions on the questionnaire showed a good distribution of responses, a high correlation with the rest of the questionnaire and excellent discrimination between patients with and without NLDO. Cronbach's alpha values were good for the overall questionnaire (0.95), and for two predetermined subscales; symptoms (0.95) and HRQL (0.85). On a 0 to 4 scale, NLDO patients had worse scores compared to non-NLDO patients for both symptoms (mean difference = 2.1; 95% confidence interval (CI): 1.8 to 2.4) and HRQL (mean difference 1.2; 95% CI: 0.8 to 1.5) subscales. NLDO patients had worse scores pre-intervention compared to post-intervention for both the symptoms (mean difference = 2.2; 95% CI: 1.6 to 2.9) and HRQL (mean difference = 1.4; 95% CI: 0.8 to 2.1) subscales. Finally, NLDO patients had worse symptom scores for affected eyes compared to unaffected eyes (mean difference = 2.3; 95% CI: 1.9 to 2.6).Conclusions-This novel NLDO questionnaire is useful in quantifying parental perception of symptoms and HRQL in childhood NLDO. The questionnaire may have a role in future clinical studies of NLDO

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Success of Simple Probing and Irrigation in Patients With Nasolacrimal Duct Obstruction and Otitis Media

Cited by 9 publications

References 8 publications

Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction

Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction

Management of Epiphora in Children- Prospective Analysis

A Symptom Survey and Quality of Life Questionnaire for Nasolacrimal Duct Obstruction in Children

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