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Lee, Ahn, Kim, and Yang: The Clinical Outcome of Endoscopic Silicone Tube Intubation for Congenital Nasolacrimal Duct Obstruction
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(7): 929-933.

Published online: 13 July 2012

DOI: https://doi.org/10.3341/jkos.2012.53.7.929

The Clinical Outcome of Endoscopic Silicone Tube Intubation for Congenital Nasolacrimal Duct Obstruction

Jung Jae Lee, MD1, Jae Hwan Ahn, MD2, Jung Lim Kim, MD2, Jae Wook Yang, MD, PhD2

1Department of Ophthalmology, DongKang Medical Center, Ulsan, Korea.

2Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address reprint requests to Jae Wook Yang, MD, PhD. Department of Ophthalmology, Busan Paik Hospital, #75 Bokji-ro, Busanjin-gu, Busan 614-735, Korea. Tel: 82-51-890-6016, Fax: 82-51-890-6329, eyeyang@inje.ac.kr

Received 20 June 2011       Accepted 2 April 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate the surgical results and clinical effectiveness of silicone tube intubation through Hasner's valve under intranasal endoscopic guidance in children with congenital nasolacrimal duct obstruction (CNDO).

Methods

The present study enrolled a total of 58 eyes of 46 children over 12 months of age diagnosed with CNDO in the Department of Ophthalmology, Inje University College of Medicine from 2003 to 2010. Patients who had previously undergone ineffective probing or had a combination of an anatomical abnormality such as secondary nasolacrimal duct obstruction were also included. The silicone tube was intubated through the Hasner's valve and observed with intranasal endoscopy; tube retention time was planned for at least 12 weeks.

Results

A total of 20 eyes were previously probed preoperatively (mean 1.7 times). After the average follow-up period of 13.5 months, the overall success of silicone intubation was 57 of 58 eyes (98%). In one failed eye, nasolacrimal obstruction was already combined preoperatively, and unintentional tube removal by the patient occurred within one week. Silicone tube reintubation was performed after four months, and CNDO symptoms improved.

Conclusions

Intranasal endoscopic observation to ensure the passage of a silicone tube through Hasner's valve decreases anatomical injury. When considering patient age and former treatment, silicone tube intubation with intranasal endoscopic observation could produce desirable results with a higher success rate.

Keywords: Congenital nasolacrimal duct obstruction, Hasner's valve, Nasal endoscope, Silicone tube intubation

Figures and Tables

Figure 1
Intranasal endoscopic observation of Hasner's valve (A) to ensure the passage of silicone tube (B).
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Table 1
Patient demographics
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Values are presented as no. of patient [eye] or mean ± SD (range).

References

1. Paul TO, Shepherd R. Congenital nasolacrimal duct obstruction: natural history and the timing of optimal intervention. J Pediatr Ophthalmol Strabismus. 1994. 31:362–367.
2. Noda S, Hayasaka S, Setogawa T. Congenital nasolacrimal duct obstruction in Japanese infants : its incidence and treatment with massage. J Pediatr Ophthalmol Strabismus. 1991. 28:20–22.
3. Ffooks OO. Dacryocystitis in infancy. Br J Ophthalmol. 1962. 46:422–434.
4. Lee SY, Chung HS, Kim HB, et al. The incidence of congenital nasolacrimal duct obstruction in Korean neonates. J Korean Ophthalmol Soc. 1989. 30:5–8.
5. Oh HS, Ahn Y. The incidence and medical treatment of congenital nasolacrimal duct obstruction in Korean infants. J Korean Ophthalmol Soc. 1995. 36:1007–1013.
6. Paul TO. Medical management of congenital nasolacrimal duct obstruction. J Pediatr Ophthalmol Strabismus. 1985. 22:68–70.
7. Petersen RA, Robb RM. The natural course of congenital obstruction of the nasolacrimal duct. J Pediatr Ophthalmol Strabismus. 1978. 15:246–250.
8. Mannor GE, Rose GE, Frimpong-Ansah K, Ezra E. Factors affecting the success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction. Am J Ophthalmol. 1999. 127:616–617.
9. Katowitz JA, Welsh MG. Timing of initial probing and irrigation in congenital nasolacrimal duct obstruction. Ophthalmology. 1987. 94:698–705.
10. Welsh MG, Katowitz JA. Timing of Silastic tubing removal after intubation for congenital nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg. 1989. 5:43–48.
11. Cho KW, Lee SY, Kim SJ. Treatment of congenital nasolacrimal duct obstruction using silicone intubation set. J Korean Ophthalmol Soc. 1995. 36:553–558.
12. Yoon TJ, Na KS, Yoon WJ. The effect of silicone tube intubation in pediatric nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2002. 43:155–159.
13. Lim CS, Martin F, Beckenham T, Cumming RG. Nasolacrimal duct obstruction in children: outcome of intubation. J AAPOS. 2004. 8:466–472.
14. Peterson NJ, Weaver RG, Yeatts RP. Effect of short-duration silicone intubation in congenital nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg. 2008. 24:167–171.
15. Melia BM, Beck RW, et al. Pediatric Eye Disease Investigator Group. Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than 4 years of age. J AAPOS. 2008. 12:445–450.
16. Durso F, Hand SI Jr, Ellis FD, Helveston EM. Silicone intubation in children with nasolacrimal obstruction. J Pediatr Ophthalmol Strabismus. 1980. 17:389–393.
17. Al-Hussain H, Nasr AM. Silastic intubation in congenital nasolacrimal duct obstruction: a study of 129 eyes. Ophthal Plast Reconstr Surg. 1993. 9:32–37.
18. Boyrivent V, Ruban JM, Ravault MP. [Role of nasolacrimal intubation in the treatment of lacrimation caused by congenital lacrimal duct obstruction in infants]. J Fr Ophtalmol. 1993. 16:532–537.
19. Kaufman LM, Guay-Bhatia LA. Monocanalicular intubation with Monoka tubes for the treatment of congenital nasolacrimal duct obstruction. Ophthalmology. 1998. 105:336–341.
20. Engel JM, Hichie-Schmidt C, Khammar A, et al. Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction. J AAPOS. 2007. 11:183–186.
21. Salari AM, Tokhmehchi MR. A simplified method for nasolacrimal silicone intubation. Acta Ophthalmol. 2008. 86:230.
22. Busse H, Müller KM, Kroll P. Radiological and histological findings of the lacrimal passages of newborns. Arch Ophthalmol. 1980. 98:528–532.
23. Ahn DH, Lew H, Kim HY, Lee SY. The effect of probing for congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 1998. 39:836–840.
24. Moon JS, Choi WC. Office probing of congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 1999. 40:2357–2361.
25. Kim KS, Park TK, Choi WC. Intranasal endoscopic diagnosis and treatment in congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2001. 42:7–12.
26. Cakmak SS, Yildirim M, Sakalar YB, et al. Is it necessary to accompany probing with endoscopy in cases of congenital nasolacrimal canal obstruction? Int J Pediatr Otorhinolaryngol. 2010. 74:1013–1015.
27. Sener EC, Onerci M. Reappraisal of probing of the congenital obstruction of the nasolacrimal system: is nasal endoscopy essential? Int J Pediatr Otorhinolaryngol. 2001. 58:65–68.
28. Kouri AS, Tsakanikos M, Linardos E, et al. Results of endoscopic assisted probing for congenital nasolacrimal duct obstruction in older children. Int J Pediatr Otorhinolaryngol. 2008. 72:891–896.
29. Dortzbach RK, France TD, Kushner BJ, Gonnering RS. Silicone intubation for obstruction of the nasolacrimal duct in children. Am J Ophthalmol. 1982. 94:585–590.
30. Beigi B, O'Keefe M. Results of Crawford tube intubation in children. Acta Ophthalmol (Copenh). 1993. 71:405–407.
31. Yazici B, Akarsu C, Salkaya M. Silicone intubation with the Ritleng method in children with congenital nasolacrimal duct obstruction. J AAPOS. 2006. 10:328–332.
32. Orhan M, Onerci M. Intranasal endoscopic silicone intubation for congenital obstruction of the nasolacrimal duct in children. Int J Pediatr Otorhinolaryngol. 1997. 41:273–278.
33. Anderson RL, Edwards JJ. Indications, complications and results with silicone stents. Ophthalmology. 1979. 86:1474–1487.
34. Park JH, Lee YJ, Kim SJ, et al. Factors affecting the outcome of silicone intubation for congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2011. 52:266–271.
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