The course of epiphora after failure of silicone intubation for congenital nasolacrimal duct obstruction

Kassif, Yanir; Rehany, Uri; David, Michal; Popko, A. S.; Rumelt, Shimon

doi:10.1007/s00417-004-1115-4

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…However, the natural course of CNDO after failure of probing is unclear. Kassif et al. (2005) showed that the rate of spontaneous resolution is 80% after the unsuccessful silicone intubation.…”

Section: Treatment Of Cndo Beyond the First Year Of Lifementioning

confidence: 99%

“…(2005) showed that the rate of spontaneous resolution is 80% after the unsuccessful silicone intubation. Spontaneous resolution post‐intervention has been reported to occur at 33–70 months (Kassif et al. 2005).…”

Section: Treatment Of Cndo Beyond the First Year Of Lifementioning

confidence: 99%

“…2005). The mechanism of resolution was thought to depend on the continuing maturation of the lacrimal drainage system as part of the development of the facial structure (Kassif et al. 2005).…”

Section: Treatment Of Cndo Beyond the First Year Of Lifementioning

confidence: 99%

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Management of congenital nasolacrimal duct obstruction

Takahashi

Kakizaki

Chan

et al. 2010

Acta Ophthalmologica

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ABSTRACT.Our review aims to provide an update of management protocols for congenital nasolacrimal duct obstruction (CNDO). Although early probing performed before the age of 1 year was traditionally recommended, many reports have since confirmed high frequencies of spontaneous resolution during the first year of life. Accordingly, a 'wait-and-see' approach, combined with conservative therapies, is judged to be the best option in infants aged < 1 year. By contrast, persistent obstruction beyond 1 year of age warrants probing as a firstline interventional therapy. However, the optimal timing for probing remains controversial. Although there remains a high possibility of spontaneous resolution after the first year of age, this must be balanced against the decrease in success rates for probing that accompanies advancing age. If conservative management fails, persistent CNDO beyond 1 year of age should be managed either by further observation or by primary probing according to the severity of symptoms. In patients in whom probing fails, advanced treatment such as balloon catheter dilation, silicone tube intubation or dacryocystorhinostomy may be considered.

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Section: Treatment Of Cndo Beyond the First Year Of Lifementioning

confidence: 99%

Section: Treatment Of Cndo Beyond the First Year Of Lifementioning

confidence: 99%

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Management of congenital nasolacrimal duct obstruction

Takahashi

Kakizaki

Chan

et al. 2010

Acta Ophthalmologica

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“…According to various authors, the success rate is between 62% and 100% [ 17 - 26 ]. Also Kassif showed that the rate of spontaneous resolution after unsuccessful intubation with silicone tube is 80% [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

Insights in the treatment of congenital nasolacrimal duct obstruction

Avram¹

2017

rjo

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Introduction: Congenital nasolacrimal duct obstruction is one of the most common causes of epiphora in newborns and the main cause of this condition is the persistence of Hasner membrane. Several treatment options are available, like conservative treatment, probing, irrigation, or more complex techniques. Objective: The objective of this paper is to discuss the efficiency of different treatment options addressing congenital nasolacrimal duct obstruction based on trials reported in literature. Methods: Clinical trials were identified on PubMed. The results were discussed regarding patient age, type of treatment and efficiency of the treatment. Results: 41 trials were reviewed. The rate of resolution according to different treatment options was the following: conservative treatment 14.2-96%, probing 78-100%, irrigation 33-100%, silicon tube intubation 62-100%, inferior turbinate fracture 54.7-97%, balloon dacryocystoplasty 77%, endoscopic intranasal surgery 92.72%, and dacryocystorhinostomy 88.2-93.33%. Conclusions: The first choice in uncomplicated cases should be a conservative treatment, which can be followed until the age of 1 year, while in complicated cases other solutions should be considered.

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“…In one study following the natural course of epiphora in children with congenital nasolacrimal duct obstruction after failure of silicone intubation, most patients (8 of the 10 eyes, 80%) with conservative management had resolution of the epiphora over a course of 33–70 months of follow-up, without complications [19]. The possible mechanism for the resolution of the epiphora over time is the continuing development and maturation of the lacrimal canals and distention of the lacrimal drainage system as part of the development of the facial structures [19]. Results of our study correspond with the theory of continuing development of the lacrimal canals in children.…”

Section: Discussionmentioning

confidence: 99%

Anatomical and Morphometric Study of the Bony Nasolacrimal Canal Using Computed Tomography

Lee

et al. 2011

Ophthalmologica

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Aims: To determine the diameters, angles and sectional area of the bony nasolacrimal canal using computed tomography for obtaining detailed anatomical knowledge of the drainage system and utilizing these measurements in planning interventions for nasolacrimal duct obstruction in adults and children. Methods: Using standard computed tomographic images, we measured the diameters, angles and sectional area of the bony nasolacrimal duct in 228 patients without nasolacrimal duct disease. Results: There was no statistically significant difference in other parameters between males and females. In particular, age had a significant effect on the angle between the bony nasolacrimal canal and the nasal floor in the pediatric patients (<10 years; p = 0.00), and pediatric patients had more acute angles than adult patients (>10 years old). Conclusions: In nasolacrimal probing of congenital nasolacrimal duct obstruction, the probe should be passed more to the posterior part of the nasal cavity. In other words, the distal part of the probe should form a more obtuse angle with the forehead in pediatric patients than in adults. This study may contribute to the establishment of a detailed anatomical and morphometric baseline of the bony nasolacrimal canal and provide useful information for the planning of interventions for nasolacrimal duct obstruction in adults and children.

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The course of epiphora after failure of silicone intubation for congenital nasolacrimal duct obstruction

Abstract: Epiphora can spontaneously resolve after failure of silicone intubation in CNLDO, and DCR should no longer considered be compulsory in such cases unless complications evolve.

Cited by 8 publications

References 25 publications

Management of congenital nasolacrimal duct obstruction

Management of congenital nasolacrimal duct obstruction

Insights in the treatment of congenital nasolacrimal duct obstruction

Anatomical and Morphometric Study of the Bony Nasolacrimal Canal Using Computed Tomography

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