Clinical Note |

Endonasal Endoscopic Dacryocystorhinostomy in Children

Michael J. Cunningham, MD; John J. Woog, MD
Arch Otolaryngol Head Neck Surg. 1998;124(3):328-333. doi:10.1001/archotol.124.3.328.
Text Size: A A A
Published online

Objective  To describe the indications, technique, and results of endonasal endoscopic dacryocystorhinostomy in children with congenital and acquired disorders of the nasolacrimal system.

Design  Retrospective case series.

Setting  Tertiary care hospital.

Patients  Four children ranging in age from 10 months to 6 years.

Intervention  Primary or revision endonasal endoscopic dacryocystorhinostomy performed via a joint otolaryngologic-ophthalmologic team approach.

Main Outcome Measures  Incidence of surgical complications and postoperative clinical status.

Results  The duration of follow-up was 10 to 24 months with a successful clinical outcome in all 4 children. Two procedures were complicated by nasal vestibule skin abrasions secondary to rotation of the drill shaft.

Conclusions  Despite the technical challenges posed by the small anatomical dimensions of the pediatric nasal airway, the combination of proper otolaryngologic endoscopic instrumentation and ophthalmologic lacrimal sac transillumination guidance allows for the safe and successful performance of endonasal endoscopic dacryocystorhinostomy in the pediatric population.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours


Place holder to copy figure label and caption
Figure 1.

Contrast-enhanced axial computed tomographic scan demonstrates a cystic enlargement of the nasolacrimal sac with lateral protrusion into the medial canthal region (arrowheads).

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Coronal computed tomographic scans document partial opacification of the right maxillary and ethmoid sinuses (A), osseous defect (arrows) in the anterior ethmoid-lacrimal bone (B), and a circumscribed fluid density (arrowhead) in the medial canthal region in both images.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

The surgical technique of endonasal endoscopic dacryocystorhinostomy. A, A rigid fiberoptic light probe is passed via the superior or inferior punctum into the lacrimal sac. B, The rhinostomy portion of the operation requires removal of both nasal mucosa and lacrimal bone under light probe guidance. C, Tenting of the lacrimal sac wall with the light probe or a standard lacrimal probe facilitates performance of the dacryocystotomy. D, A bicanalicular silicone intubation of the surgically created nasolacrimal fistula completes the procedure.

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Endoscopic Dacryocystorhinostomy. Craniomaxillofac Trauma Reconstr 2013;6(2):67-74.

Users' Guides to the Medical Literature
Clinical Scenario

The Rational Clinical Examination
Endoscopy is the accepted reference standard test for the patient with dyspepsia as it has both a...