A Prospective Longitudinal Study to Evaluate the Outcomes of Success of Endoscopic DCR in Pediatric Age Group
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ORIGINAL ARTICLE
A Prospective Longitudinal Study to Evaluate the Outcomes of Success of Endoscopic DCR in Pediatric Age Group Renu Poonia1 • Yogesh Aseri1 • Digvijay Singh Rawat1 • B. K. Singh1
Received: 20 June 2020 / Accepted: 25 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract Children with nasolacrimal duct obstruction (NLDO) have different therapeutic approach from that used in adults. Dacryocystorhinostomy (DCR) is the most common procedure in adults but it is less frequently carried out in children, indicated in children which are refractory to probing. The objective of the study is to report a series of 30 cases of paediatric epiphora who underwent endoscopic endonasal dacryocystorhinostomy surgery, for primary obstruction of nasolacrimal duct and results, outcomes of success are evaluated. This is a prospective and noncomparative review of 30 cases of epiphora aged between 3 and 9 years from April 2018 to March 2019. The main outcome measures assessed were determined by the resolution of symptoms and the patency of the lacrimal anatomy confirmed by syringing or irrigating the nasolacrimal duct. Secondary outcomes included the presence of such complications as bleeding, scarring, and/or persistent epiphora and infection. In our study 30 patients underwent unilateral DCR surgery in NLDO. Out of 30 patients males were 17 and females were 13. The overall success rate of endoscopic DCR was 90%, and failed cases were mainly due to pre-saccal obstruction. No major complications were reported, minor complications occurred in about 60% of cases. Analysis of the results indicated that EDCR was safe and an effective therapeutic approach for treating nasolacrimal duct obstruction in pediatric age group patients having NLDO. It’s considered as an alternative procedure to external dacryocystorhinostomy after a failed conservative treatment. & Yogesh Aseri [email protected] 1
Keywords Endoscopic DCR (EDCR) Pediatrics Naso lacrimal duct obstruction Dacryocystitis
Introduction The term epiphora is taken from the Greek word epifora, which in turn is derived from the root words epi (upon) and ferein (to bring). Epiphora means overflow of tears from the eye. It is a commonest symptom of lacrimal disorders. During the first year of life it is a very common condition affecting 20% of infants because of a persistent membranous web at Hasner’s valve but spontaneous resolution usually occurs in approximately 96% within the first 12 months [1].. Epiphora can alter refraction. Other causes of epiphora include post-traumatic obstruction of the lacrimal system, punctual malposition or functional disorder of the lacrimal passages [2]. And acquired causes of nasolacrimal duct obstruction [3, 4]. The incidence of epiphora is higher in children with craniofacial abnormalities and Down syndrome. [5]. About 90% of these obstructions resolve spontaneously with simple conservative methods [6] like nasolacrimal probing, dilatation, nasolacrimal intubation, with gentle massage over the lacrimal sac, topical a
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