THE ENDOSCOPIC APPROACH FOR CONGENITAL NASOLACRIMAL DUCT OBSTRUCTION

Probing of the nasolacrimal duct is a common procedure in children wit h congenital stenosis. Although simple probing of the nasolacrimal duc t is successful in a majority of patients, a number of failures occur. In those temporary intubation of the nasolacrimal duct with a silicon e drain may solve the problem. We performed silicone intubation in 11 infants under nasal endoscopic control. By this improved visualization of the inferior meatus, the procedure was facilitated. In four childr en the probe was unable to pierce the nasal mucosa and stayed in the s ubmucosal space. An incision of the nasal mucosa was needed before the probe could be passed into the nasal lumen. We believe that this situ ation, inability to pierce the nasal mucosa, may explain a number of f ailures of simple probing. It is therefore advisable, especially if in itial probing has failed, to repeat the procedure under endoscopic con trol.