Auto-stable unknotted bicanalicular tubes placed under direct endoscopic view in congenital lacrimal stenosis: time consuming or promising results ?
Author: Sylvie Vandelanotte
Base Hospital / Institution: AZ ST Jan Hospital Bruges
Rapid fire oral presentation
Abstract ID: 24-271
Purpose
To evaluate the efficacy of unknotted autostable bicanalicular tubes (Ritleng plus tubes) in the treatment of congenital lacrimal duct obstruction, placed under direct endoscopic view.
Operation duration, placement technique and removal, complications and results are reviewed.
Methods
Retrospective case serie. Patients with primary congenital duct stenosis (> 1 year) and patients with failure after primary probing underwent lacrimal probing with placement of un-knotted bicanalicular tubes.
Procedure was performed under general anesthesia.
The anatomic appearance of the membrane of Hassner was visualized with the help of endoscopic view. In case of cystic appearance of the membrane of Hassner, a partial removal of the cyst wall was performed.
These tubes are placed with the Ritleng intubation system.
The tubes werd removed in the policlinic after an average of 8 weeks without need of anesthesia. Complications (cheese-wiring of the lacrimal punctae, early extrusions), removal method and results were reviewed.
Results
Most patients we treated, were failures after earlier primary probing.
All patients were successfully intubated with the Ritleng bicanalicular lacrimal tubes. Time duration of operation depends is sligthly longer and is dependent from learning curve, nose anatomy and primary versus secondary procedure.
There was no cheese-wiring. We observed relief from symptoms in most cases.
The early extrusions did not affect the succes outcome.
Removal of the tubes was easy and painless for the children.
Conclusion
Using the autostable un-knotted bicanalicular intubation system under direct endoscopic view for congenital lacrimal stenosis is a reliable and non-traumatizing procedure. Although time duration of the operation and learning curve is on average slightly longer, this method gives promising long-term results and could be recommended as a first step procedure in lacrimal probing.
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