ABSTRACT

Aim

The purpose of this study was to report the profile and outcomes of children with an earlier failed probing that was performed without endoscopy guidance.

Methods

Retrospective interventional case study was performed on all the patients who were referred with a diagnosis of a single or multiple failed probing from Jan 2016 to June 2019 to a tertiary care Dacryology center. All the patients had a blind probing without an endoscopy assistance before referral. The parameters evaluated were patient demographics, number of earlier probings, prior operative notes, clinical presentation, findings of endoscopy guidance during the repeat procedure, simple vs complex CNLDO, types of complex CNLDO, management, complications and outcomes.

Results

One hundred eyes of 82 children had a failed probing experience without endoscopic guidance elsewhere. The mean age of the children was 55.7 months (range: 9–168 months). Of these, 63 eyes underwent repeat probing under endoscopic guidance, 35 eyes being simple CNLDO (35/63, 55.5%), and 28 eyes (28/63, 44.5%) being complex CNLDO. Among the complex subset, balloon dacryoplasty was performed for five cases and monoka-Crawford stents for eight cases under direct endoscopy visualization. Buried probes were managed successfully by standard protocols of probe exteriorization. The two cases of misdirected probes were re-directed under endoscopy guidance for appropriate recanalization and the single case of granuloma at the NLD opening was excised followed by intubation without any recurrence.

Conclusion

Endoscopy guidance plays a crucial role in the management of CNLDO with an earlier failed probing.

中文翻译：

---

先天性鼻泪管阻塞更新研究（CUP 研究）：报告 III。早期无内镜引导探查失败分析

摘要

目标

本研究的目的是报告在没有内窥镜指导的情况下进行早期探查失败的儿童的概况和结果。

方法

对 2016 年 1 月至 2019 年 6 月诊断为单次或多次探查失败的所有患者进行回顾性介入病例研究。所有患者在转诊前都在没有内窥镜帮助的情况下进行了盲探。评估的参数是患者人口统计数据、早期探查次数、先前的手术记录、临床表现、重复手术期间内镜指导的结果、简单与复杂 CNLDO、复杂 CNLDO 的类型、管理、并发症和结果。

结果

82 名儿童的 100 只眼在其他地方没有内窥镜引导时探诊失败。儿童的平均年龄为 55.7 个月（范围：9-168 个月）。其中，63眼在内镜引导下重复探查，单纯CNLDO 35眼（35/63，55.5%），复杂CNLDO 28眼（28/63，44.5%）。在复杂的亚组中，5例行球囊泪膜成形术，8例行monoka-Crawford支架在内窥镜直接可视化。通过探针外化的标准协议成功地管理了埋藏的探针。在内镜引导下将两例错向探头重新定向以进行适当的再通，单例NLD开口处的肉芽肿被切除后插管，未复发。

结论

内镜引导在早期探查失败的 CNLDO 的管理中起着至关重要的作用。