Primary endoscopic endonasal dacryocystorhinostomy for pediatric nasolacrimal duct obstruction

A systematic review

Jeyasakthy Saniasiaya, Baharudin Abdullah, Salina Husain, De Yun Wang, Zahiruddin Wan Mohammad

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Epiphora secondary to nasolacrimal duct obstruction is common in the pediatric age group. The mainstay treatment among these young patients has been conservative. Once epiphora becomes recalcitrant, however, an external or an endonasal approach is considered. Objective: Endoscopic dacryocystorhinostomy (EDCR) entails creating an opening from the lacrimal sac directly into the nasal cavity to counteract nasolacrimal duct obstruction. We reviewed the literature to determine the effectiveness and the safety of primary EDCR to treat pediatric nasolacrimal duct obstruction. Method: A literature search was conducted by using a number of medical literature data bases for the period from 1995 to 2016. The following search words were used either individually or in combination: epiphora, nasolacrimal duct obstruction, endoscopic dacryocystorhinostomy, powered endoscopic dacryocystorhinostomy, laser-assisted endoscopic dacryocystorhinostomy, children, congenital, acquired, presaccal obstruction, and postsaccal obstruction. In addition, a few articles were identified based on the experience and information provided by the senior authors (B.A., S.H., D.Y.W.). The search was conducted over a 1-month period (January 2017). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were followed when possible. Results: Only 10 original clinical research articles were selected based on our objectives and selection criteria. All the studies were at level of evidence III: nonrandomized and noncomparative prospective or retrospective case series. Altogether, 313 patients with ages that ranged from 4 months to 18 years were enrolled. A total of 352 EDCRs were performed that were either single sided (n 313) or bilateral (n 39). The most common causes of the obstruction were classified as congenital, followed by idiopathic, and then acquired. A meta-analysis was not performed because of the heterogeneity of the patient groups and variability of the methods used to measure outcomes. Conclusion: Analysis of the results indicated that EDCR was an effective, safe therapeutic approach to treating nasolacrimal duct obstruction in pediatric COP patients. It should be considered as an alternative procedure to external dacryocystorhinostomy after a failed conservative treatment.

Original languageEnglish
Pages (from-to)328-333
Number of pages6
JournalAmerican Journal of Rhinology and Allergy
Volume31
Issue number5
DOIs
Publication statusPublished - 1 Sep 2017

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Nasolacrimal Duct
Dacryocystorhinostomy
Pediatrics
Lacrimal Apparatus Diseases
Meta-Analysis
Nasal Cavity
Patient Selection
Lasers
Age Groups
Outcome Assessment (Health Care)
Databases
Guidelines
Safety
Therapeutics
Research

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Primary endoscopic endonasal dacryocystorhinostomy for pediatric nasolacrimal duct obstruction : A systematic review. / Saniasiaya, Jeyasakthy; Abdullah, Baharudin; Husain, Salina; Wang, De Yun; Mohammad, Zahiruddin Wan.

In: American Journal of Rhinology and Allergy, Vol. 31, No. 5, 01.09.2017, p. 328-333.

Research output: Contribution to journalArticle

Saniasiaya, Jeyasakthy ; Abdullah, Baharudin ; Husain, Salina ; Wang, De Yun ; Mohammad, Zahiruddin Wan. / Primary endoscopic endonasal dacryocystorhinostomy for pediatric nasolacrimal duct obstruction : A systematic review. In: American Journal of Rhinology and Allergy. 2017 ; Vol. 31, No. 5. pp. 328-333.
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