Nasolacrimal duct intubation in the treatment of congenital nasolacrimal duct obstruction in older children

Purpose The purpose of this study was to investigate the outcomes of nasolacrimal duct intubation in the primary treatment of congenital nasolacrimal duct obstruction (CNLDO) in children aged 7 years and older. Methods Thirty children aged >= 7 years who underwent primary unilateral nasolacrimal duct intubation because of CNLDO were enrolled in this study. CNLDO diagnosis was based on signs and symptoms including typical epiphora, increased tear meniscus, recurrent or persistent mucopurulent discharge, and an abnormal dye disappearance test (DDT). Surgical success was defined as complete resolution of previous signs and symptoms and DDT grade 0-1. Results The mean age was 10.7 +/- 2.5 years (ranging from 7 to 15 years). Of the 30 patients, 18 were male and 12 were female. The mean follow-up period was 8.8 +/- 3.4 months (ranging from 6 to 16 months). The mean silicone tube removal time was 4.6 +/- 1.1 months (ranging from 3 to 6 months). The complete resolution of signs and symptoms with DDT grade 0-1 was observed in 22 of 30 cases (73.3%) during the follow-up period. The mean age of the patients with unsuccessful outcomes was 12.7 +/- 1.4 years, whereas that of the patients with successful outcomes was 10.0 +/- 2.4 years, and the difference was statistically significant (P = 0.006). No serious intra-and/or postoperative complication was observed. Conclusions The current study demonstrates that nasolacrimal duct silicone intubation with intranasal endoscopic visualization has favorable outcomes as a primary treatment of persistent CNLDO in children aged 7 years and older. It can be used to reduce the need for dacryocystorhinostomy which is a more invasive procedure.