학술논문

Lacrimal drainage obstruction and dacryocystorhinostomy in children.
Document Type
Article
Source
Eye. Jul2008, Vol. 22 Issue 7, p918-924. 7p. 3 Charts, 1 Graph.
Subject
*DACRYOCYSTORHINOSTOMY
*NASAL surgery
*PEDIATRIC surgery
*SURGICAL stents
*SAFETY
LACRIMAL apparatus surgery
Language
ISSN
0950-222X
Abstract
Purpose: To determine the outcome of dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NLDO) in children. Methods: A review of medical records of 104 cases (82 patients) of paediatric DCR who underwent DCR at the Sydney Eye Hospital from 1995 to 2004. The main outcome measures included post-operative symptomatic relief of presenting symptoms, complications, subjective visibility of any scar, and general satisfaction. Statistical methods included χ2 tests, and Student's t-tests for the comparison of variables among groups. Results: Ninety-four external, 10 endoscopic primary procedures, and five revision procedures were included. Fifty-six of the cases were primary NLDO, and 48 were secondary NLDO. The mean follow-up was 1.44 years. Average age at surgery was 6.6±4.2 years (mean±SD). Ninety-one eyes needed DCR for the involvement of the lower lacrimal outflow system, and 13 eyes were NLDO associated with congenital punctual/canalicular dysgenesis.Most of the complications of external DCR were related to Jones tube placement. Five cases (4.8%) needed DCR revision. There was a significantly higher incidence of revision surgery in the non-stented group (P<0.01), and the Jones tube group (P<0.001) as compared with the silicone intubation stent group. Conclusions: External DCRs have acceptable long-term clinical and cosmetic results, and low post-operative complication rate. Cases with punctal stenosis or those requiring Jones tube insertion are associated with a higher complication rate. Silicone intubation is associated with a lower need for operative revision. Eye (2008) 22, 918–924; doi:10.1038/sj.eye.6702769; published online 16 March 2007 [ABSTRACT FROM AUTHOR]