Dacryocystitis, or obstruction of the nasolacrimal canal is one of the most common eye diseases at an early age. 10-15% of newborns have dacryocystitis.
The correct and only effective method of treating dacryocystitis is probing, which is performed to recover the free passage of tear fluid into the nasal cavity.
The most ideal age for conducting probing in a drug-induced sleep is 2-6 months. But do not wait for the child to reach 6 months of age specifically. With prolonged inflammation, the walls of the tear sac become flabby, and it may lose its function of the pump that pumps the tear.
Before conducting probing, the child is examined by a cardiologist, a pediatrician and an otolaryngologist.
Therefore, modern methods of probing assume, first, the correct anesthesia, which is not deep but sufficient for the child to feel nothing.
Second, the availability of correct tools, third, of course, the availability of a highly qualified surgeon, and, fourth, the possibility of introducing a contrast agent through the upper lacrimal passages and receiving it through the lower ones as evidence of the recovery of the patency of the nasolacrimal canal.
Probing is conducted in the best hospital in Moscow, where parents before and after the operation are with the child in the most comfortable conditions. An hour after the manipulation, the child is discharged.
Conventional methods of probing (without medication) may not allow checking whether the surgeon has passed the lacrimal passages with the probe completely, whether the patency of the nasolacrimal canal is recovered for passing the tear or not, as it is impossible to wash it to see the liquid itself in the nasal cavity.
If the barrier that led to the obstruction is very low in the nasolacrimal passages, for example, in the area of the entrance, the surgeon, in this case, has a feeling that the probe has completely passed, but the nasolacrimal canal is still not recovered. It is no accident that in 30% of cases during the procedure, a sleepless baby requires repeated probing and, unfortunately, more than one.
Typically, doctors who are sure that the only way to treat an obstruction is probing and who do not pay attention to the fact that the cause may be completely different, attempt for repeated probing thereby ultimately damaging the nasolabial canal, which makes it impossible to recover it further.
Therefore, the issue related to the correct diagnosis of what is the cause of obstruction of the nasolacrimal canal is very important.
Even if we find one case of this unusual obstruction in a hundred cases of ordinary obstruction, one child will, unfortunately, be maimed.
What to do if the nasal canal is damaged or incorrectly formed? In such cases, carry out stenting of the nasolacrimal canal or dacryocystorhinostomy.
Stenting is conducted in cases of improper development of the canaliculi.
To do this, we install a special stent. In complex cases, it is required to form a new fistula, which ensures the outflow of tears into the nasal cavity with subsequent stenting. These operations are performed together with the otolaryngologist under the process video control of manipulation.
Before conducting probing and stenting, children are necessarily examined by narrow-focused specialists, a cardiologist, a pediatrician, and an otolaryngologist, to exclude contraindications to anesthesia. Their conclusions are necessary for the anesthetist who selects the ideal method for providing a drug-induced sleep and who is responsible for the overall condition of the child during this procedure.
