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Pediatric Nasolacrimal Duct Obstruction

  • Rona Z. Silkiss
Chapter

Abstract

Pediatric (congenital) nasolacrimal duct obstruction (PNLDO) is the most common cause of persistent epiphora in childhood. The incidence of PNLDO is 5–6% (ranging from 1.2 to 30%) of births. Spontaneous resolution is reported in 90% within the first year of life. Our treatments are geared to the 10% of patients that do not experience spontaneous resolution. This chapter discusses the typical presentation of the tearing patient as well as the differential diagnosis. The traditional therapeutic paradigm including primary probing, secondary probing with stent, choice of stent, and dacryocystorhinostomy is discussed with recent data to inform decision-making.

Keywords

Pediatric nasolacrimal duct obstruction Nasal lacrimal duct probing Monocanalicular intubation Bicanalicular intubation Balloon dacryoplasty Endoscopic dacryocystorhinostomy External dacryocystorhinostomy 

Supplementary material

419986_5_En_8_MOESM1_ESM.mp4 (8.5 mb)
Video 8.1 Nasolacrimal duct obstruction probing. Video courtesy of Dr. Angela Dolmetsch (MP4 5596 kb)
419986_5_En_8_MOESM2_ESM.mp4 (155.4 mb)
Video 8.2 Probing and stenting. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Probing-and-Stenting.htm (MP4 159146 kb)
419986_5_En_8_MOESM3_ESM.mp4 (95.5 mb)
Video 8.3 Probing and stenting of nasolacrimal duct with fluorescein irrigation. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/probe-and-stent-w-irrigation.htm (MP4 97811 kb)
419986_5_En_8_MOESM4_ESM.mp4 (101.9 mb)
Video 8.4 Endoscopic retrieval of Crawford stent. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/3/9-endoscopic-retrieval-crawford-stent.htm (MP4 104346 kb)
419986_5_En_8_MOESM5_ESM.mp4 (103.2 mb)
Video 8.5 Options for retrieving Crawford stents. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/5/13-stent-retrieval.htm (MP4 105629 kb)
419986_5_En_8_MOESM6_ESM.mp4 (20.5 mb)
Video 8.6 Inferior turbinate infracture. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Inferior-turbinate-infracture.htm (MP4 21024 kb)
419986_5_En_8_MOESM7_ESM.mp4 (47.1 mb)
Video 8.7 Intranasal cyst in congenital nasolacrimal duct obstruction (NLDO). Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/7/8-intranasal-cyst.htm (MP4 48251 kb)
419986_5_En_8_MOESM8_ESM.mp4 (2.9 mb)
Video 8.8 Endoscopic dacryocystorhinostomy. Video by Dr. Rona Z. Silkiss. (MP4 2999 kb)
419986_5_En_8_MOESM9_ESM.mp4 (257.6 mb)
Video 8.9 External dacryocystorhinostomy. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/External-DCR.htm (MP4 263826 kb)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Ophthalmic Plastic, Reconstructive and Orbital SurgeryCalifornia Pacific Medical CenterSan FranciscoUSA
  2. 2.Silkiss Eye SurgeryOaklandUSA

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