A multidisciplinary approach to atypical lacrimal obstruction in childhood

Purpose: This study explores the diagnosis and management of unusual anomal ies involving the canaliculi, nasolacrimal duct, nasal cavity, and sinuses in childhood. Methods: A case series of eight children with lacrimal outflow anomalies ra nging from distal nasolacrimal duct cyst formation to persistent dacryocyst itis following failed probing or silicone intubation were reviewed retrospe ctively. Diagnostic studies including intranasal endoscopy and preoperative or intraoperative dacryocystography (DCG) were of value. Results: Treatment modalities included endoscopically guided resection of l acrimal cyst mucosa, endoscopic dacryocystorhinostomy (DCR), and monocanali cular or bicanalicular intubation of the lacrimal outflow system. In our se ries, endoscopic surgery was well tolerated by all patients with improvemen t in symptoms. Conclusions: This initial experience suggests that endoscopic techniques ma y be useful in the management of atypical lacrimal outflow obstruction in c hildhood.