RESULTS OF DACRYOSCINTIGRAPHY IN MASSAGE OF THE CONGENITALLY BLOCKED NASOLACRIMAL DUCT

Between November 1990 and November 1993, 580 children with lacrimal ou tflow obstruction were examined at the Children's Hospital of Philadel phia. After excluding patients previously treated for nasolacrimal duc t obstruction, we obtained a prospectively selected series of 20 child ren for this study. These patients underwent dacryoscintigraphy before and immediately after lacrimal sac massage to investigate the effect of external compression on fluid movement within the lacrimal outflow system. In 12 patients, tracer did not enter the lacrimal outflow syst em on the side(s) of obstruction. The absence of radiopharmaceutical c orrelated with clinical obstruction. Tn eight patients, tracer was not ed to enter the lacrimal sac. After massage of the lacrimal sac, we ob served progression of the tracer in five of the eight subjects. In the se eight subjects, the pre- and postmassage tear column measurements s howed a relative increase of 34.3%. Massage of eight clinically normal ducts showed a relative increase of 2.4% (p = 0.06). We conclude that progression of the tear column after lacrimal massage can be demonstr ated on dacryoscintigraphy.