Rhinoscopy assisted lacrimal probing – minimal invasive and effective therapeutic option for children with congenital nasolacrimal duct obstruction

Background
Congenital nasolacrimal duct obstruction (CNLDO ) is a common developmental anomaly, and in most cases, obstruction is located at the distal end of the nasolacrimal duct. The rate of spontaneous resolution of CNLDO is up to 96% during the first year of life, and, therefore, most authors advise only medical treatment in the first months of life. When obstruction persists, lacrimal probing is performed. Conventionally, the next steps in surgical treatment are lacrimal intubation and dacryocystorhinostomy. The intranasal approach was first proposed many years ago, but became possible only after the development of advanced endoscopic rhinosurgery. At present, it is widely used to treat CNLDO .

Objectives
To evaluate the effectiveness of rhinoscopy assisted lacrimal probing as a treatment for congenital nasolacrimal duct obstruction in children.

Material and methods
We enrolled 14 children with CNLDO to this case series study. All children underwent surgery between 01.03.2016 and 30.03.2018. Data about symptoms and previous treatment were first collected, surgery was then performed, and all patients were then reexamined postoperatively and data about results recorded

Results
The age range was 6–152 months (median 30 months). Four (4) patients had no history of previous surgery, and ten (10) had undergone lacrimal probing before. The overall final success rate was 85.71% (12/14 patients, including 2 infants with dacryocystitis)

Conclusions
In our group of patients, endoscopy assisted lacrimal probing is an effective method of treatment for CNLDO . We suggest to use this method in cases of children older than 12 months with one or more unsuccessful probing, with infants with dacryocystitis, and always before considering dacryocystorhinostomy.