Journal List > J Korean Ophthalmol Soc > v.60(12) > 1139572

Oh and Kim: Effect of Nasal Wall Fixation of Silicone Tube Intubation on Congenital Nasolacrimal Duct Obstruction

Abstract

Purpose

We determined the effects of silicone tube tip fixation on the nasal wall using an absorbable suture during silicone tube intubation in patients with congenital nasolacrimal duct obstruction.

Methods

Patients (55:71 eyes) diagnosed with congenital nasolacrimal duct obstruction and who underwent silicone tube intubation were divided into two groups: those in which the silicone tube was fixed to the nasal wall using an absorbable suture (fixed group) or not (non-fixed group). We investigated the percentage of silicone tube displacement, the time for displacement, the success of surgery, and the method of removing the silicone tube after surgery.

Results

The mean age, percentage of early displacement within 1 month, time to displacement, and success rate of surgery were 2.4 years, 0% (0/35), 1.4 months, and 100% (35/35) in the fixed group (35 patients) and 1.8 years, 44% (16/36), 0.8 months, and 97% (35/36) in the non-fixed group (36 patients), respectively. Both groups were able to remove the silicone tube simply through lacrimal punctum at the outpatient clinic.

Conclusions

In patients with congenital nasolacrimal duct obstruction, silicone tube fixation at the nasal wall after silicone tube intubation can prevent early displacement of silicone tubes within 1 month. This is a simple and effective technique because it re-moves the silicone tube through the lacrimal punctum without general anesthesia or intravenous anesthesia.

References

1. Schnall BM. Pediatric nasolacrimal duct obstruction. Curr Opin Ophthalmol. 2013; 24:421–4.
crossref
2. Sevel D. Development and congenital abnormalities of the abdominal apparatus. J Pediatr Ophthalmol Strabismus. 1981; 18:13–9.
3. MacEwen CJ, Young JD. Epiphora during the first year of life. Eye (Lond). 1991; 5:596–600.
crossref
4. Guerry D 3rd, Kendig EL Jr. Congenital impatency of the abdominal duct. Arch Ophthal. 1948; 39:193–204.
5. Lee SY, Chung HS, Kim HB, et al. The incidence of congenital abdominal duct obstruction in Korean neonates. J Korean Ophthalmol Soc. 1989; 30:5–8.
6. Paul TO. Medical management of congenital nasolacrimal duct obstruction. J Pediatr Ophthalmol Strabismus. 1985; 22:68–70.
crossref
7. Petersen RA, Robb RM. The natural course of congenital abdominal of the nasolacrimal duct. J Pediatr Ophthalmol Strabismus. 1978; 15:246–50.
8. Dortzbach RK, France TD, Kushner BJ, Gonnering RS. Silicone intubation for obstruction of the nasolacrimal duct in children. Am J Ophthalmol. 1982; 94:585–90.
crossref
9. Leone CR Jr, Van Gemert JV. The success rate of silicone abdominal in congenital lacrimal obstruction. Ophthalmic Surg. 1990; 21:90–2.
10. Kraft SP, Crawford JS. Silicone tube intubation in disorders of the lacrimal system in children. Am J Ophthalmol. 1982; 94:290–9.
crossref
11. Beigi B, O'Keefe M. Results of Crawford tube intubation in children. Acta Ophthalmol (Copenh). 1993; 71:405–7.
crossref
12. Veloudios A, Harvey JT, Philippon M. abdominal placement of abdominal nasolacrimal tubes. Ophthalmic Surg. 1991; 22:225–7.
13. Kim KS, Park TK, Choi WC. Intranasal endoscopic diagnosis and treatment in congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2001; 42:7–12.
14. Anderson RL, Edwards JJ. Indications, complications, and results with silicone stents. Ophthalmology. 1979; 86:1474–87.
crossref
15. Lekskul A, Khamapirad B, Nimvorapun T. Simple technique for silicone intubation in congenital nasolacrimal duct obstruction. J Med Assoc Thai. 2004; 87:1082–6.
16. Lee TS, Jang M. A modified technique of bicanalicular silicone tube intubation in congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2009; 50:984–8.
crossref
17. Ratliff CD, Meyer DR. Silicone intubation without intranasal abdominal for treatment of congenital nasolacrimal duct obstruction. Am J Ophthalmol. 1994; 118:781–5.
18. Migliori ME, Putterman AM. Silicone intubation for the treatment of congenital lacrimal duct obstruction: successful results abdominal the tubes after six weeks. Ophthalmology. 1988; 95:792–5.
19. Patrinely JR, Anderson RL. A review of lacrimal drainage surgery. Ophthalmic Plast Reconstr Surg. 1986; 2:97–102.
crossref
20. Park J, Lee YJ, Kim SJ, Jang JW. Factors affecting the outcome of silicone intubation for congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2011; 52:266–71.
crossref
21. Kim J, Kang SM. The clinical outcomes of early silicone tube abdominal in congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2018; 59:393–6.
22. Peterson NJ, Weaver RG, Yeatts RP. Effect of short-duration abdominal intubation in congenital nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg. 2008; 24:167–71.
23. Sabermoghaddam AA, Hosseinpoor SS. Preventing silicone tube extrusion after nasolacrimal duct intubation in children. J Ophthalmic Vis Res. 2010; 5:280–3.
24. Müller DA, Snedeker JG, Meyer DC. Two-month longitudinal study of mechanical properties of absorbable sutures used in ortho-pedic surgery. J Orthop Surg Res. 2016; 11:111.
crossref

Figure 1.
Post-operative photograph of right nose in 8 years old patient. Silicone tube (red arrow) is loosely fixed on mucocuta-neous junction of nasal lateral wall by absorbable suture (yellow arrow).
jkos-60-1128f1.tif
Table 1.
Patient characteristics
Characteristic Non-fixed group (eye = 36) Nasal-fixed group (eye = 35) p-value
Sex      
 Male 20 19 0.914*
 Female 16 16  
Age (years) 1.8 ± 1.53 2.4 ± 1.59 0.004
Side      
 Right 20 18 0.727*
 Left 16 17  

Values are presented as mean ± standard deviation or number.

* Chi-squared test

Mann-Whitney U test.

Table 2.
Tube retention time and success rate
Variable Non-fixed group (eye = 36) Nasal-fixed group (eye = 35) p-value
Tube retention time (months      
 Normal removal 3.0 ± 0.71 (15) 2.2 ± 0.35 (16) 0.001*
 Early displacement 0.8 ± 0.75 (21) 1.4 ± 0.37 (19) 0.001*
  0–4 weeks 13 0 0.000
  4–16 weeks 8 19
  Total 21 19 0.731
Success rate (%) 97 (35/36) 100 (35/35) 0.321

Values are presented as mean ± standard deviation or number unless otherwise indicated.

* Mann-Whitney U test

chi-squared test.

TOOLS
Similar articles