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Treatment of Congenital Nasal Aplasia Associated Nasolacrimal Duct Obstruction: Evaluating the Efficacy of Endoscopic Assisted Dacrocystorhinostomy
Oluwaseun A. Adetayo, MD1, 2
Lorelei J. Grunwaldt, MD1, 2
Anand R. Kumar, MD1, 2
1) Children's Hospital of Pittsburgh of UPMC
2) Department of Plastic Surgery, University of Pittsb
2013-03-07
Presenter: Oluwaseun A Adetayo
Affidavit:
The project above is the original work of the presenting fellow and faculty listed including study and paper design, data analysis, and final editing.
Director Name: Joseph E. Losee
Author Category: Fellow Plastic Surgery
Background and Purpose:
Nasolacrimal duct obstruction (NLDO) in children with congenital nasal agenesis with or without proboscis remains poorly characterized. Currently, no consensus exists regarding timing of nasolacrimal reconstruction or optimal surgical technique. This study aims to evaluate nasolacrimal reconstruction outcomes of symptomatic nasal agenesis patients treated with endoscopic- assisted dacrocystorhinostomy (EADCR).
Methods:
A retrospective review of symptomatic nasal agenesis patients with NLDO treated using EADCR over 36 months was performed to evaluate nasolacrimal reconstruction outcomes. Two patients were identified that fulfilled the study criteria. Both underwent EADCR with concomitant placement of silicone stent. Pre and post-operative CT scans were obtained and patients were followed clinically and radiologically for evidence of resolution of symptoms and dilated lacrimal sacs after stent removal.
Results:
Two patients were identified who met inclusion criteria. The average age at presentation
was 33 months (6 months - 5 years). The average age at operation was 34.9 months (6.75 months - 5.25years). Average time to removal of stent was 19.3 weeks (18.5 – 20 weeks). The average follow-up was 7 months (4 - 10 months). Both patient underwent genetic testing and were nonsyndromic. Both patients underwent EADCR and had improvement in symptoms of epiphora. One patient with a history of dacryocystitis developed a superficial infection that was treated conservatively.
Conclusions:
Limitations of this study include a small sample size and short duration of follow-up.
However, our results demonstrate that EADCR is a viable option for treatment of NLDO in children with congenital anomalies and aberrant anatomy.
