Different Modalities for Management of Pediatric Epiphora

Mostafa Talaat Abd-El Hakeem,1 Adel Abdallah,1 Rasha Abdelmoneim,1 Ahmed Khaleel,1 Raafat Abdallah2 1Otorhinolaryngology Department, Faculty of Medicine, Minia University, Minia, Egypt; 2Ophthalmology Department, Faculty of Medicine, Minia University, Minia, EgyptCorrespondence: Mostafa Talaat Abd-El Hakeem, Email mostafatalaat1981@gmail.comObjective: This study assessed the efficacy and safety of different modalities for managing nasolacrimal duct obstruction and epiphora in children over one year.Methods: We performed a non-randomized prospective study on 98 children (149 eyes) with epiphora and no history of lacrimal operation. The selected candidates attended the ENT and ophthalmology outpatient clinics of Minia University Hospital, seeking to treat epiphora that may or may not be associated with sinonasal pathology. Nasolacrimal operations involved a joint approach involving an otorhinolaryngologist and an ophthalmologist.Results: Ninety-eight children (149 eyes) were identified. Ages varied from 1 to 12 years old. Conservative measures were successful in 32.6% of children. Silicone stents were used in 27.5% of the interventions with a mean time to removal of 3– 6 months. The success rate for dacryocystorhinostomy (DCR) was 85.7%. Revision surgery was performed in 10% of probing cases, 8% of intubation cases, and 14.3% of DCR patients. The concomitant chronic sinonasal problems were evident in 62.2% of patients.Conclusion: Conservative measures, probing, endonasal nasolacrimal intubation, endoscopic DCR, and external DCR are safe and effective procedures for epiphora in children. Also, correcting concomitant nasopharyngeal or sinonasal diseases in epiphora patients is crucial for successful management, overcoming recurrence, and minimizing morbidity.Keywords: pediatric epiphora, pediatric dacryocystorhinostomy, endonasal nasolacrimal intubation, sinonasal pathology