Szemészet, 2012 (149. évfolyam, 1-4. szám)

2012-03-01 / 1. szám

Pediatric endoscopical dacryoplasty with a microdrill

Fig. 4. Three channel endoscope of 1 1 □□ jum CVitroptik T, Pülydiagnost; Pfaffenhofen, Germany]

these do not have ports to allow further instrumentation. We used instead a three channel endoscope of 1100 цт (Vitroptik T, Polydiagnost; Pfaffenhofen, Germany) which allows a wash canula, a channel for the microoptic and another for the microdrill

(Fig-4).

The dimensions of the child’s lacrimal outflow system can

make the procedure technically challenging. By pushing the endoscope, there is a risk of perforation. A false pathway leads to immediate swelling, which makes further investigation very difficult. It is therefore advisable to go through the upper canaliculi which allow more mobility when turning the instrument towards the nose as the upper eyelids are

more flexible. Damage to the upper canaliculi has also a less serious prognosis.

Conclusions

We recommend the use of microsurgical intervention by endoscopic transcanalicular dacryoplasty with a microdrill in children above the age of two years with persistent symptoms. This is a minimally invasive procedure with limited trauma, no endonasal bleeding, quick recovery and no pain. It should be considered as a possible alternative to the endonasal technique.

Disclosures

None of the authors have proprietary interest and no financial support was received. The operation was performed with informed consent of the patient's parents who also gave their permission to publish this case report.

The paper has not been presented as a part of a meeting and has not been published elsewhere, yet.

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