Dacryocystitis, or obstruction of the nasolacrimal canal, 10-15% of newborns have dacryocystitis, it is one of the most common eye diseases at an early age.
The correct and only effective method of treating dacryocystitis is probing, which is performed to recover the free passage of tear fluid into the nasal cavity.
The tactic of treatment of dacryocystitis used by us allows carrying out precise and targeted medical actions taking into account the cause of the obstruction and saving the child from this unpleasant defect in 100% of cases.
Before conducting probing, the child is examined by a cardiologist, a pediatrician, and an otolaryngologist.
It is extremely important to perform probing very accurately, so that not to harm the baby. Therefore, we conduct probing for children exclusively when they are in a drug-induced sleep. We are not talking about some strong anesthesia, we are talking about a very superficial drug-induced sleep, in which the child simply breathes through a mask and wakes up just a few seconds after the procedure ends. There is no need to be afraid of this because the benefits that parents, doctors, and, what is most important, our little patient, receive from this method of manipulation are significantly higher than what is obtained with conventional methods of probing without anesthesia.
Second, we use the best imported stents that can pass through the most complex, indirect nasolacrimal channels. It often happens that the probe rests on some bone bend and it is impossible to carry out further probing, or the nasolacrimal canal itself becomes damaged since the probe is inflexible. This is why we use the most modern elastic stents made of high-quality silicone, which are procured in America and Europe.
When probing, we insert a special probe into the nasolacrimal canal, providing total control over the probe when it passes the lacrimal passages, taking into account their anatomical structure. Immediately after the procedure, we wash the canal with contrast and make sure that the patency is fully recovered.
Therefore, modern methods of probing assume, first, the correct anesthesia, which is not deep but sufficient for the child to feel nothing, second, the availability of correct tools, third, of course, the availability of a highly qualified surgeon, and, fourth, the possibility of introducing a contrast agent through the upper lacrimal passages and receiving it through the lower ones as evidence of the recovery of the patency of the nasolacrimal canal.
Probing is conducted in the best hospital in Moscow, where parents before and after the operation are with the child in the most comfortable conditions. An hour after the manipulation, the child is discharged.
Conventional methods of probing have two serious fundamental drawbacks. The first is that manipulations are conducted almost without anesthesia. The child is in pain, it twitches and screams, and in this case, iatrogenic complications may occur. An iatrogenic complication is a complication caused by a doctor. In conditions where manipulations require the highest precision from the surgeon and there is no room for error, any awkward movement associated with the restless state of the child leads to damage to the lacrimal passages by the tool.
The second complication. Conventional methods of probing (without medication) may not allow checking whether the surgeon has passed the lacrimal passages with the probe completely, whether the patency of the nasolacrimal canal is recovered for passing the tear or not, as it is impossible to wash it to see the liquid itself in the nasal cavity.
If the barrier that led to the obstruction is very low in the nasolacrimal passages, for example, in the area of the entrance, the surgeon, in this case, has a feeling that the probe has completely passed, but the nasolacrimal canal is still not recovered. It is no accident that in 30% of cases during the procedure, a sleepless baby requires repeated probing and, unfortunately, more than one.
With modern, correct probing methods, we have the ability to enter contrast and check whether the nasolacrimal canal is recovered.
There is an opinion among doctors and patients that any obstruction is the result of congenital webs that are present in the nasolacrimal canal. However, this is not the only reason for probing.
There is also an obstruction that is associated with an incorrect formation of the entrance of the nasolacrimal canal, in the place where it opens into the nasal cavity.
The second reason for the obstruction of the nasolacrimal canal in newborns is an incomplete formation of the nasolacrimal canal, when it ends blindly, not a tube but some sort of vial.
Therefore, it is wrong to follow the idea that after probing all the problems in the child will end.
If it has these two types of patency disorders, then, in this case, probing will not be a way that will help. Moreover, typically, doctors who are sure that the only way to treat an obstruction is probing and who do not pay attention to the fact that the cause may be completely different, attempt for repeated probing thereby ultimately damaging the nasolabial canal, which makes it impossible to recover it further.
Therefore, the issue related to the correct diagnosis of what is the cause of obstruction of the nasolacrimal canal is very important.
Even if we find one case of this unusual obstruction in a hundred cases of ordinary obstruction, one child will, unfortunately, be maimed.
What to do if the nasal canal is damaged or incorrectly formed? In such cases, carry out stenting of the nasolacrimal canal or dacryocystorhinostomy.
Young mothers often mistake the obstruction for conjunctivitis and limit themselves to local anti-inflammatory treatment. Conjunctivitis passes quickly on the background of correctly selected treatment, dacryocystitis, not. With conjunctivitis, there is no nasal congestion, the purulent discharge does not increase when pressing on the area of the lacrimal sac. Obstruction is usually a congenital condition, and conjunctivitis is an acquired condition. Do not practice self-treatment. At the first symptoms of the inflammatory process, show the child to a pediatric ophthalmologist who will make a precise diagnosis.