Treatment of Obstructed Nasolacrimal Duct by Lacrimal Stent without Fluoroscopic Guidance

Lee, Jong Soo; Jeong, Geun; Lee, Sang Hyup; Oum, Boo Sup

Abstract

This study was carried out to evaluate and investigate the clinical utility of the plastic nasolacrimal stents (Song's tube) without fluoroscopic guidance in treatment of the obstructed nasolacrimal duct. The anesthesia was performed with Tetra-caine contained epinephrine in the nasal mucosa, proparcaine in the conjunctival sac and 2% lidocaine for infratrochlear block. The plastic stent were placed in the lacrimal system with the head portion lying in the lacrimal sac and body in the nasolacrimal duct and projecting into the inferior meatus of the nasal cavity. Complete resolution of epiphora was accomplished in 92(97%) of the 95 eyes with mean follow up of 8.5 months (minimal 6 months, maximal 18 months), and there were no significant complications under this procedure. This noninvasive procedure was indicated the anatomic obstruction of the nasolacrimal system, especially obstruction was at the junction between the lacrimal sac and nasolacrimal duct or stenosis of the nasolacrimal duct, which can be the probing as possbile. The use of the plastic nasolacrimal stents without fluoroscopic guidance have many advantages, as follow; There are no surgical dacryocystorhinostomy procedure, simple surgical technique and short duration of procedure, no risk of exposure radiation, and no needs of fluoroscope instrument and radiologist. Although evaluation of a longer-term follow up will be needed to determine the effectiveness of this thechnique, the utility of the plastic nasolacrimal stents without fluoroscopic guidance seem to be of value in primary management of the obstructed nasolacrimal duct, prior to the dacryocystorhinostomy procedure in proper indication of the nasolacrimal duct obstruction.