A.N. BOCHKAREVA¹, G.P. SMOLIAKOVA^1,2, V.V. EGOROV^1,2, P.A. BANSHCHIKOV¹

¹Khabarovsk branch of S. Fyodorov Eye Microsurgery Federal State Institution, 211 Tikhookeanskaya Str., Khabarovsk, Russian Federation, 680033

²Postgraduate Institute for Public Health Workers, 9 Krasnodarskaya Str., Khabarovsk, Russian Federation, 680000

 Bochkareva A.N. ― ophthalmologist of the Department of Reconstructive Plastic Surgery, tel. (4212) 72-27-92, e-mail: naukakhvmntk@mail.ru, ORCID: 0000-0002-3575-0894

Smoliakova G.P. ― Doc. Med. Sc., Professor, ophthalmologist of the Clinical-Expertise Department, Professor of the Ophthalmology Department, tel. (4212) 22-51-21, e-mail: naukakhvmntk@mail.ru, ORCID: 0000-0002-6943-5518

Egorov V.V. ― Doc. Med. Sc., Professor, Director, Head of the Department of Ophthalmology, tel. (4212) 22-51-21, e-mail: naukakhvmntk@mail.ru, ORCID: 0000-0002-9888-7353

Banshchikov P.A. ― Head of the Department of Reconstructive Plastic Surgery, tel. (4212) 72-27-92, e-mail: naukakhvmntk@mail.ru, ORCID: 0000-0002-0854-4104

(For citation: Bochkareva A.N., Smoliakova G.P., Egorov V.V., Banshchikov P.A. Results of application of modern endoscopic technologies of nasolacrimal duct intubation for congenital dacryocystitis. Practical Medicine. 2018)

 The study objective was to assess the effectiveness of endoscopic bicanalicular nasolacrimal duct (ND) intubation with a silicone tube for congenital dacryocystitis (CD) and to justify the optimal periods for its removal based on determination of acid-base balance (pH) of wound exudate in nasal cavity.

The subject of study were 25 children (25 eyes) with CD operated in Khabarovsk branch of S. Fyodorov Eye Microsurgery Federal State Institution. Endoscopic bicanalicular intubation with a silicone tube by FCI (France) was carried out to all children for reconstruct the tears outflow.

Ophthalmic examination included determination of pH of wound exudate in nasal cavity. Criteria of effectiveness of CD surgical treatment after silicone tube removal was monthly indicators of active and passive patency of ND by diagnostic irrigation of ND during 12 months after surgery.

Normalization of pH of wound exudate in nasal cavity in children with uncomplicated CD was registered by the 4^thweek after surgery, in children with recurrent CD ― by the 6^thweek, which coincided with full disappearance of clinical signs of inflammation. Silicone tubes were removed at the specified time.

Dye disappearance test had good results in 24 children throughout observation period (12 months) after silicone tube removal. Only one child (4%) had recurrence 6 months after surgery.

The speed of cessation and intensity of inflammation in children with CD after bicanalicular ND intubation are interrelated with pH of wound exudate in nasal cavity. In accordance with the obtained results, in infants with uncomplicated CD, removal of silicone tube is advisable 4 weeks after its installation, in children of early age with recurrent CD ― not earlier than 6 weeks.

Key words: congenital dacryocystitis, endoscopic visualization, silicone tube intubation.

REFERENCES

1. Aznabaev M.T., Munirova L.N. On the issue of prevention of recurrence of dacryocystitis after surgical treatment. Vestnik oftal’mologii, 2008, no. 3, pp. 42-43 (in Russ.).
2. Arestova N.N., Katargina L.A. Algorithm of operative and drug treatment of neonatal dacryocystitis. Rossiyskaya pediatricheskaya oftal’mologiya, 2013, no. 1, pp. 50-52 (in Russ.).
3. Belova O.V., Kashura O.I. Nash opyt lecheniya vrozhdennogo dakriotsistita i chastichnoy neprokhodimosti sleznykh putey u detey rannego vozrasta [Our experience in the treatment of congenital dacryocystitis and partial obstruction of the lacrimal duct in young children]. Sovremennye metody diagnostiki i lecheniya zabolevaniy sleznykh organov: mater. konf. Moscow, 2005. Pp. 54-56.
4. Buben L.K., Gridyushko E.M. K voprosu o lechenii dakriotsistitov u detey [o the question of the treatment of dacryocystitis in children]. Sovremennye metody diagnostiki i lecheniya zabolevaniy sleznykh organov: sb. tr. konf. Moscow, 2005. Pp. 89-91.
5. Rykov S.A., Barinov Yu.V., Barinova A.A. Treatment of recurrence of dacryocystitis in young children. Oftal’mologicheskiy zhurnal, 2011, no. 3, pp. 34-38 (in Russ.).
6. Galeeva G.Z. Optimizatsiya lecheniya klinicheskikh form dakriotsistita novorozhdennykh v zavisimosti ot infektsionnoy etiologii: avtoref. dis. … kand. med. nauk [Optimization of treatment of clinical forms of neonatal dacryocystitis depending on the infectious etiology. Synopsis of dis. PhD med. sciences]. Moscow, 2013. 24 p.
7. Lebedeva O.S., Chinenov I.M. Diagnostics and treatment of recurrent congenital dacryocystitis and stenosis of the nasal duct in children. Rossiyskaya pediatricheskaya oftal’mologiya, 2008, no. 2, pp. 32-34 (in Russ.).
8. Cherkunov B.F. Bolezni sleznykh organov [Diseases of the lacrimal organs]. Samara, 2001. Pp. 207-219.
9. Brzheskiy V.V. Taktika lecheniya stenozov nososleznogo protoka u detey [Tactics of treatment of stenosis of the nasal duct in children]. Vserossiyskaya shkola oftal’mologa, 10-ya: Sb. nauch. tr. Moscow, 2011. Pp. 389-396.
10. Gibbs D.C. New probe for the intubation of lacrimal canaliculi with silicone rubber tubing. Br. J. Ophtalmol, 1967, vol. 51, no. 3, p. 198.
11. Volkov V.V., Brzheskiy V.V. Oftal’mokhirurgiya s ispol’zovaniem polimerov [Ophthalmic surgery using polymers]. Saint Petersburg: Gippokrat, 2003. P. 134.
12. At’kova E.L., Beloglazov V.G., Malaeva L.V. Silicone intubation at the initial forms of dacryocystitis. Oftal’mologicheskiy zhurnal, 1992, no. 2, pp. 82-83 (in Russ.).
13. Vladimirova E.B. Morfofunktsional’nye izmeneniya slizistoy obolochki verkhnechelyustnykh pazukh posle radikal’noy operatsii: avtoref. dis. … kand. med. nauk [Morphofunctional changes in the mucous membrane of the maxillary sinuses after radical surgery. Synopsis of dis. PhD med. sciences]. Moscow, 2002. 24 p.
14. Khiggins K. Rasshifrovka klinicheskikh laboratornykh analizov [Interpretation of clinical laboratory tests]. Moscow: Laboratoriya znaniy, 2006. 376 p.
15. Lopatin A.S. Rinit: patogeneticheskie mekhanizmy i printsipy farmakoterapii [Rhinitis: pathogenetic mechanisms and principles of pharmacotherapy]. Moscow: Littera, 2013. 368 p.
16. Dolman P.J. Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorinostomy. Ophthalmology, 2003, vol. 110, no. 1, pp. 78-84.