Simple technique for silicone intubation in congenital nasolacrimal duct obstruction

Objective: To propose a simple and low cost technique of using the simple materials in the operating room for silicone intubation in case of nasolacrimal duct obstruction in children after failed probing. Method: The study was a consecutive case series. Three patients with congenital nasolacrimal duct obstruction aged 42, 51 and 72 months were referred to the authors. Their symptoms persisted after probing twice with or without infracture inferior turbinate. The authors decided to insert a silicone tubing by using an 18-gauge, intravascular catheter as a channel to place a silicone tubing into the nasolacrimal system. Success was defined as a complete resolution of symptoms and signs (tearing, crusting, discharge, regurgitation on pressure over the lacrimal sac) after silicone intubation. Results: All three patients were free of symptoms and signs after insertion of silicone tubing and an average 5.5 months (9, 6, 1.5 months) after removal of the silicone tubing. There were no intraoperative complications. No unplanned silicone tubing removal was needed and also no complications associated with silicone stent, such as punctal erosion, corneal erosion or granuloma formation occurred. Conclusion: This simple and low cost technique using an intravascular catheter as a channel to place the silicone tubing into the nasolacrimal system in case of congenital nasolacrimal duct obstruction in children works well. This new technique is not only inexpensive but also effortless with no complications.