The technique of nasendoscopy in the evaluation of nasolacrimal duct obstruction in children

Abstract

Epiphora in infancy is most commonly the result of failure of canalisation of the nasolacrimal duct and most cases resolve spontaneously within 12 months. Lacrimal probing is the standard operative treatment when conservative expectant management fails. While this carries a high success rate, it does not reliably localise the site of obstruction, can create a false passage and may induce traumatic stenosis in the lacrimal passages. Nasendoscopy in conjunction with the lacrimal probing overcomes these problems as the procedure is performed under direct vision. The precise site of opening of the nasolacrimal duct is ascertained, the nature of obstruction established and the risks of false passage creation minimised. We report this technique of endoscopic assessment of lacrimal probing, and the outcome results of twenty such procedures performed on thirteen children.