Effect of Nasal Wall Fixation of Silicone Tube Intubation on Congenital Nasolacrimal Duct Obstruction

Jae Hyun Oh; Sang Duck Kim

doi:10.3341/jkos.2019.60.12.1128

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

Original Article

J Korean Ophthalmol Soc 2019;60(12):1128-1133.

Published online: 25 September 2019

DOI: https://doi.org/10.3341/jkos.2019.60.12.1128

Effect of Nasal Wall Fixation of Silicone Tube Intubation on Congenital Nasolacrimal Duct Obstruction

Jae Hyun Oh, MD^1,², Sang Duck Kim, MD^1,²

¹Department of Ophthalmology, Wonkwang University College of Medicine, Iksan, Korea

²Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea

Address reprint requests to Sang Duck Kim, MD Department of Ophthalmology, Wonkwang University College of Medicine, #895 Muwang-ro, Iksan 54538, Korea Tel: 82-63-859-1370, Fax: 82-63-855-1801 E-mail: sangduck@wku.ac.kr

Received 19 July 2019 Revised 4 September 2019 Accepted 6 December 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Absorbable suture, Congenital nasolacrimal duct obstruction, Silicone tube displacement, Silicone tube fixation, Silicone tube intubation

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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).

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.

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