Endoscopic intranasal surgery for congenital nasolacrimal duct obstruction-A new approach

Objective: Congenital nasolacrimal duct obstruction can be treated with a spectrum of techniques, starting with conservative massage to more invasive dacryocystorhinostomy. There has been controversy regarding the optimal treatment procedure. We introduced a unique technique to treat congenital nasolacrimal duct obstruction and analyzed its success rate and complications. Methods: In a retrospective study, we introduced the results of our technique. This technique consisted of endoscope guided inspection of the Hasner valve area, trial of irrigation, incision of the imperforate Hasner valve and irrigation again. If these maneuvers were not effective, more invasive procedure, probing under endoscopic control was done. Results: 48 children (55 eyes) were included in the study. Complete improvement was achieved in 51/55 eyes (92.72% success rate). We did not encounter any early or late complication. Conclusions: The great majority of the congenital nasolacrimal duct obstruction stem from Hasner valve area pathologies. The endoscopic intervention of this area is very effective and safe way of treatment. This technique should be added to the armamentarium of the congenital nasolacrimal duct obstruction treatment. (C) 2013 Elsevier Ireland Ltd. All rights reserved.