Transnasal anchor thread facilitates silicone intubation in congenital nasolacrimal duct obstruction

Background. In silicone intubation of the nasolacrimal duct for congenital obstruction, retrieval of the guide thread behind the inferior turbinate ca n be difficult and time consuming. To facilitate this maneuver a modificati on of the conventional technique has been developed. Patients and method. In the conventional technique,a hollow probe was inser ted into both lacrimal puncti and pushed downward into the nasal cavity. A guide thread was forwarded into the pharynx. Using the same hollow probe, a third guide thread was inserted transnasally and also forwarded into the p harynx. These three threads were pulled out of the pharynx transorally and tied together. Pulling on the nasal aspect of the transnasal guide brought all guides back into the pharynx and out of the nose. The intubation was co mpleted in the conventional way. Results. The new method was evaluated in 13 children. With the conventional technique the mean duration of the operation was 35 min, but the time requ ired varied greatly among individuals due to retrieval of the guides. In co ntrast, no guide retrieval problem occurred using the new technique, and th e average duration was reduced to 25 min. No adverse effect was observed. Conclusion. Using a simple modification, difficulties with the retrieval of the guide thread could be avoided,thus facilitating the procedure of nasol acrimal duct intubation and reducing its duration.