Volume 29

Number 2 July 2018

Trans Canalicular Diode LASER DCR with ‘Bari Device’ in Pediatric Cases

DOI: https://doi.org/10.47648/jmsr.2018.v2902.02

Bhuiyan Md. B B1 , Akber A2 , Islam M S3 , Chowdhury K U4 , Choudhury M5

Abstract

Epiphora due to Nasolacrimal duct obstruction (NLDO) is common in chidren. About 5% to 20% infants show evidence of congenital Nasolacrimal duct obstruction with symptoms 1,2. Most of them (95%) cured by conservative management. Majority of the remaining symptomatic patients are cured by probing, repeat probing, probing with incubation and Baloonplasty procedures. About 4% of the patients need surgical intervention. Conventional Dacryocystorhinostomy (DCR) is the main treatment of choice in these cases till to date. DCR means creation of an alternate pathway between lacrimal sac and nasal cavity to drain tear when nasolacrimal duct (NLD) is blocked. There are different surgical techniques available for DCR. These includes conventional or external DCR, endoscopic DCR, endoscopic Laser DCR, transcanalicular or endocanalicular Laser DCR. In adult DCR can be carried out comfortably by the conventional or newly developed endoscopic approach. Narrow space, inadequate development of anatomical landmark makes both the conventional & endoscopic DCR difficult in children. Long term success rate of External DCR in pediatric patients is less in comparison to adult due to vigorous growth of tissue in a child. Laser DCR has been tried but long term success rate is not up to the mark. Several observations like- primary osteum closure, cicatrix formation with middle turbinate and nasal septum, granulation tissue formation- all are more in children due to marked fibroblastic response. So Laser DCR is a challenge in pediatric patients.

Keywords:


  1. Associate Professor, Department of Ophthalmology

    Holy Family Red Crescent Medical College, Dhaka

  2. Assistant Professor, Department of Ophthalmology

    President Abdul Hamid Medical College, Kishorgonj

  3. Associate Professor, Department of Anesthesiology

    Bangabandhu Sheikh Mujib Medical University, Dhaka

  4. Ex-Registrar, Department of Otolaryngorhinology

    Holy Family Red Crescent Medical College, Dhaka

  5. Associate Professor and Head of Ophthalmology

    Holy Family Red Crescent Medical College, Dhaka

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Volume 29, Number 2 July 2018
Page: 45148