Dilatation and stenting for naso-lacrimal duct obstruction: A pilot project

Purpose: Obstruction of the naso-lacrimal duct has traditionally been treat ed by dacryocystorhinostomy. This pilot project aimed to evaluate the use o f stents as an alternative approach to the treatment of naso-lacrimal duct obstruction. Methods: Six patients with naso-lacrimal duct obstruction underwent a prepr ocedural dacryocystogram to confirm the site of obstruction. Under local an aesthesia, they subsequently underwent dilatation of the naso-lacrimal duct using a guide mire and a plastic dilator aided by fluoroscopy and digital subtraction imaging. The stent was then placed with its head in the lacrima l sac and tail protruding out of the naso-lacrimal duct into the inferior m eatus. Dacryocystography was repeated to confirm patency. Patients mere fol lowed up for a minimum of 12 months. Results: The procedure was successfully completed in four of the six patien ts. In one patient, we failed to negotiate the guide wire and in one, a fal se passage mas created. All four successful cases mere rendered asymptomati c and their lacrimal passages remained patent at 12 months. Conclusion: Naso-lacrimal duct dilatation and stenting is a viable alternat ive to conventional dacryocystorhinostomy in the treatment of naso-lacrimal duct obstruction and merits a larger trial.