실리콘관의 돌출 및 누소관 열창 발생을 감소시키기 위한 변형된 관 삽입술

A Modified Technique of Bicanalicular Silicone Tube Intubation in Congenital Nasolacrimal Duct Obstruction

Purpose: To introduce a modified technique of bicanalicular silicone tube intubation, which can reduce slitting of the canaliculus and protrusion of the tube. Methods: This study included 46 patients who underwent modified surgery for Congenital Nasolacrimal Duct (CNLD) obstruction. To be included in this study, patients were older than 13 months and had a history of failed probing. Using our modified technique, tube lengths can be appropriately adjusted by either pulling or releasing the tube at the medial canthus until a tube loop is in place without any tension to the upper and lower canaliculi. Two threads of silicone tube were tied together using 5-0 nylon over a silicone sponge (5×5 mm) and left within the nasal cavity for several months without fixation to the nasal mucosa. A successful surgery was clinically defined as no epiphora and no dye retention in the conjunctival sac. Results: The mean age of patients at the time of surgery was 32.8 (±18.9) months. There were 22 males and 24 females. Prior to intubation, patients had been probed an average of 1.5 (±1.3) times, and the mean follow-up period was 12.6 (±14.2) months. The tube was removed at 5.4 (±1.3) months postoperatively on average. The success rates were 88%. Tube protrusions occurred in three eyes, and canalicular splittings were recorded in two eyes. No other serious complications were encountered. Conclusions: This new technique might enable us to remarkably reduce both protrusion and slitting of the canaliculus in bicanalicular silicone intubation for congenital nasolacrimal duct obstruction.