Szemészet, 2012 (149. évfolyam, 1-4. szám)
2012-03-01 / 1. szám
Tnanscanalicular endoscopically controlled dacnyoplasty with a microdrill in a 4-yearold child - A case report von Lovenberg Eszter1, Prof Agnes Bankfalvi2, Prof Zoltán Zs. Nagy3 1Eye Clinic Detmold, Detmold, Germany institute of Pathology and Neuropathology, University Clinic Essen, Germany 3Department of Ophthalmology, Semmelweis University, Budapest, Hungary Correspondence to Agnes Bankfalvi Prof, M.D. Institute of Pathology and Neuropathology University Clinic Essen, Germany Phone: ++492017232893 Fax: ++492017232893 E-mail: agnes.bankfalvi@uk-essen.de Keywords dacryocystitis, transcanalicular endoscopic dacryoplasty, microdrill A 4 year old girl with persistent chronic conjunctivitis and recurrent bilateral dacryocystitis with purulent discharge was treated by transcanalicular endoscopic dacryoplasty with a microdrill after probing with irrigation at the age of 3 had failed. Ten months after surgery the child is well with excellent functional and cosmetic results. To the best of our knowledge, this is the first report on using a microdrill in endoscopically controlled transcanalicular microsurgery of the lacrimal drainage system in a child. Stenoses of the lacrimal pathways are uncommon in children after the first 12 months. Various conservative techniques (massage, topical antibiotics, probing and intubation of the lacrimal ducts) are used to resolve these disorders. When noninvasive methods fail, surgical procedures are indicated. Minimal invasive, transcanalicular lacrimal surgery has been possible since the development of microendoscopes in the early 1990ies (1). Miniature endoscopes with fiber optics enable the direct visualization of the lacrimal drainage system and attached instruments permit decimalization of stenoses without external skin incision. Herein we report of our experience with transcanalicular endoscopic dacryoplasty with a microdrill in a 4-year-old child. Case report A 4-year-old girl presented to us with bilateral persistent chronic conjunctivitis and recurrent 52
