Probing and bicanalicular silicone tube intubation under nasal endoscopy in congenital nasolacrimal duct obstruction

To evaluate the beneficial effects of nasal endoscopy on preventing complications during probing and bicanalicular silicone intubation, and to determine the structural nasal abnormalities in congenital nasolacrimal duct obstruction. Probing and silicone tube intubation under nasal endoscopy were performed in 37 eyes of 26 patients who ranged in age from 7 to 60 months (mean, 18.8 +/- 13.4 months). By nasal endoscopy, the inferior turbinate and meatus appeared normal in 15 patients (58%), whereas 11 patients (42%) had hypertrophy of the inferior turbinate and/or stricture in the inferior meatus. Twenty-four of 26 eyes (92%) were cured by probing only. We performed silicone tube intubation and cured 11 of 12 eyes (92%) including two failures. Of 14 eyes that had undergone failed probings elsewhere, the success rate was 92.8% (13 of 14 eyes). The overall success rate of probing and silicone tube intubation under nasal endoscopy was 97%. Nasal endoscopy during probing and bicanalicular silicone tube intubation is useful especially in selected cases of failed probings. Nasal endoscopy should assist the inexperienced surgeon in preventing trauma to the nasal base and septal mucosa, hemorrhage, and passage of the probe under the mucosa rather than through the ostium.