Congenital Nasolacrimal Duct Obstruction - Early Diagnosis and Graded Therapeutic Approach as Key Points for Successful Management.

IF 1.9 4区医学 Q2 OPHTHALMOLOGY

Seminars in Ophthalmology Pub Date : 2024-05-24 DOI:10.1080/08820538.2024.2358328

Jens Heichel

{"title":"Congenital Nasolacrimal Duct Obstruction - Early Diagnosis and Graded Therapeutic Approach as Key Points for Successful Management.","authors":"Jens Heichel","doi":"10.1080/08820538.2024.2358328","DOIUrl":null,"url":null,"abstract":"Purpose: Epiphora in childhood is a frequent symptom that is typically associated with Congenital nasolacrimal duct obstruction (CNLDO). Nevertheless, inflammatory pathologies of the ocular surface as well as inside the eye, or even congenital glaucoma, must be considered in the differential diagnosis.Methods: A comprehensive literature review concerning CNLDO was conducted. Different therapeutic steps are categorized and summarized in order to reflect the existing staged therapeutic concept.Results: For CNLDO, a staged therapeutic concept is applicable, resulting in a cure rate of approximately 95% with only conservative or minimally invasive intervention. This concept includes five steps that encompass therapeutic interventions with increasing complexity. It includes conservative techniques, followed by probing and syringing, transcanalicular approaches without or with lacrimal intubation, and dacryocystorhinostomy which is the ultima ratio.Conclusion: To preserve the topographic anatomy as much as possible, therapeutic recommendations enable stepwise and individualized management of children with CNLDO.","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9000,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08820538.2024.2358328","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Epiphora in childhood is a frequent symptom that is typically associated with Congenital nasolacrimal duct obstruction (CNLDO). Nevertheless, inflammatory pathologies of the ocular surface as well as inside the eye, or even congenital glaucoma, must be considered in the differential diagnosis.

Methods: A comprehensive literature review concerning CNLDO was conducted. Different therapeutic steps are categorized and summarized in order to reflect the existing staged therapeutic concept.

Results: For CNLDO, a staged therapeutic concept is applicable, resulting in a cure rate of approximately 95% with only conservative or minimally invasive intervention. This concept includes five steps that encompass therapeutic interventions with increasing complexity. It includes conservative techniques, followed by probing and syringing, transcanalicular approaches without or with lacrimal intubation, and dacryocystorhinostomy which is the ultima ratio.

Conclusion: To preserve the topographic anatomy as much as possible, therapeutic recommendations enable stepwise and individualized management of children with CNLDO.

查看原文本刊更多论文

先天性鼻泪管阻塞--早期诊断和分级治疗是成功治疗的关键。

目的：儿童期外溢是一种常见症状，通常与先天性鼻泪管阻塞（CNLDO）有关。然而，在鉴别诊断时还必须考虑眼表和眼内的炎症性病变，甚至先天性青光眼：方法：对有关 CNLDO 的文献进行了全面回顾。方法：对有关 CNLDO 的文献进行了全面回顾，对不同的治疗步骤进行了分类和总结，以反映现有的分阶段治疗概念：结果：分阶段治疗概念适用于 CNLDO，只需保守或微创干预，治愈率约为 95%。这一概念包括五个步骤，治疗干预的复杂程度不断增加。它包括保守技术、探查和注射、不插泪管或插泪管的经颅方法以及泪囊鼻腔造口术（这是最高比例）：结论：为尽可能保留地形解剖结构，治疗建议可对 CNLDO 患儿进行分步和个性化治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Seminars in Ophthalmology OPHTHALMOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Seminars in Ophthalmology offers current, clinically oriented reviews on the diagnosis and treatment of ophthalmic disorders. Each issue focuses on a single topic, with a primary emphasis on appropriate surgical techniques.