Dacryocystorhinostomy outcomes for congenital nasolacrimal duct obstruction associated with craniofacial abnormalities.
Publication/Presentation Date
9-18-2025
Abstract
PURPOSE: To compare the clinical characteristics and outcomes of pediatric patients with and without craniofacial abnormalities who underwent dacryocystorhinostomy (DCR) for recalcitrant congenital nasolacrimal duct obstruction (CNLDO).
METHODS: This multicenter retrospective cohort study included all patients < 17 years of age who underwent DCR for CNLDO over a 20-year period, from 2003 to 2023. Outcome measures included residual epiphora following surgery and need for additional surgery including DCR revision.
RESULTS: A total of 40 patients (55 eyes) underwent DCR, of whom 28 (51%) had associated craniofacial abnormalities. Mean age at surgery was 6.3 ± 4.0 years, and 30 (55%) were female. There were no significant differences in age at surgery, sex, or surgical approach between isolated CNLDO and CNLDO associated with craniofacial abnormalities, but the craniofacial cohort was significantly more likely to require multispecialty surgical care (43% vs 7% [P < 0.05]) and have proximal lacrimal system pathology (OR = 7.92, P = 0.001). In the craniofacial cohort, 46% of eyes had residual symptoms following surgery compared with 26% in the isolated group (OR = 3.3, P = 0.06), and patients with craniofacial abnormalities who underwent multispecialty surgery were significantly more likely to have complete symptom resolution (OR = 8.33, P = 0.017). In the craniofacial group, there were 6 revisions; in the isolated group, 2.
CONCLUSIONS: In our patient cohort, CNLDO associated with craniofacial abnormalities had a higher likelihood of persistent epiphora following DCR than isolated CNLDO, but multidisciplinary surgical care was associated with improved outcomes. Surgeons should be prepared to address proximal lacrimal pathology at the time of DCR in children with craniofacial abnormalities.
First Page
104643
Last Page
104643
ISSN
1528-3933
Published In/Presented At
Ashby, G. B., Sinha, K., Kuchhangi, A. D., Odorico, S. K., Oatts, J. T., & Wagner, L. H. (2025). Dacryocystorhinostomy outcomes for congenital nasolacrimal duct obstruction associated with craniofacial abnormalities. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 104643. Advance online publication. https://doi.org/10.1016/j.jaapos.2025.104643
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
40975386
Department(s)
Department of Pediatrics
Document Type
Article