Early loss of monocanalicular silicone tubes in congenital nasolacrimal duct obstruction: incidence, predictors, and effect on outcome.

Abstract

PURPOSE:

To study predictors and implications on outcome of premature silicone tube-loss, a post-operative complication of monocanalicular intubation (MCI) performed for treatment of congenital nasolacrimal duct obstruction (CNLDO).

METHODS:

We conducted a retrospective analysis of cases of post-operative loss of monocanalicular silicone tubes occurring at one medical center from January 2007 to December 2013.

RESULTS:

During the study period monocanclicular silicone tubes were lost in 24/54 eyes (44%) of 19/46 children. Multivariate regression analysis identified bilateral intubation as an important predictor of early tube-loss (r=0.54, P=0.006). Seven of eight (88%) children who had both eyes intubated prematurely lost their tubes compared to 12/38 (32%) children who had unilateral intubation (P=0.005). Treatment success was lower in eyes with early tube-loss (17/24 eyes, 71%) compared to eyes with full tube retention (25/30 eyes, 83%), however this difference was not statistically significant (P=0.333). In our study, treatment outcome correlated with duration of intubation (r=0.51, P=0.002). Surgical success was achieved in 33/39 eyes (85%) in which the tubes were retained at least 2 months compared to 7/15 eyes (47%) with shorter period of intubation (P=0.012).

CONCLUSIONS:

Spontaneous tube-loss is a post-operative complication of monocanalicular silicone intubation that can occur more frequently than previously reported in certain populations. Tube-loss occurring soon after surgery is often associated with persistent symptoms and increased need of reoperation.

• Authors: Gad Dotan, Oded Ohana, Igal Leibovitch, Chaim Stolovitch
• Journal: International journal of pediatric otorhinolaryngology (Int J Pediatr Otorhinolaryngol) Vol. 79 Issue 3 Pg. 301-4 (Mar 2015) ISSN: 1872-8464 [Electronic] Ireland
• PMID: 25595447 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Silicones

Topics

• Child, Preschool
• Dacryocystorhinostomy (adverse effects, instrumentation)
• Female
• Health Services Needs and Demand
• Humans
• Incidence
• Intubation (adverse effects, instrumentation)
• Lacrimal Duct Obstruction (congenital, therapy)
• Male
• Prosthesis Failure
• Reoperation
• Retrospective Studies
• Silicones
• Time Factors
• Treatment Outcome