Probing and bicanalicular silicone tube intubation under nasal endoscopy in congenital nasolacrimal duct obstruction

Purpose: To evaluate the beneficial effects of nasal endoscopy on preventin g complications during probing and bicanalicular silicone intubation, and t o determine the structural nasal abnormalities in congenital nasolacrimal d uct obstruction. Methods: Probing and silicone tube intubation under nasal endoscopy were pe rformed in 37 eyes of 26 patients who ranged in age from 7 to 60 months (me an, 18.8 +/- 13.4 months). Results: By nasal endoscopy, the inferior turbinate and meatus appeared nor mal in 15 patients (58%), whereas II patients (42%) had hypertrophy of the inferior turbinate and/or stricture in the inferior meatus. Twenty-Four of 26 eyes (92%) were cured by probing only. We performed silicone tube intuba tion and cured II of 12 eyes (42%) including two failures. Of 14 eyes that had undergone failed, probings elsewhere, the success rate was 92.8% (13 of 14 eyes). The overall success rate of probing and silicone tube intubation under nasal endoscopy was 97%. Conclusion: Nasal endoscopy during probing and bicanalicular silicone tube intubation is useful especially in selected cases of failed probings. Nasal endoscopy should assist the inexperienced surgeon in preventing trauma to the nasal base and septal mucosa, hemorrhage, and passage of the probe unde r the mucosa rather than through the ostium.