Relationship Between Nasolacrimal Duct Obstruction and Otitis Media

Abstract

Abstract: : Purpose: Initial probing and irrigation (P&I) has been reported as a successful measure for treating nasolacrimal duct obstruction (NLDO).¹ However, the presence of otitis media (OM) has been reported to significantly decrease this success.² The purpose of this study was to examine the effect of OM on the success of P&I for NLDO. Methods: All patients who underwent P&I at the Saint Louis University Eye Institute between 2001-02 were prospectively studied. A preoperative questionnaire assessed laterality of NLDO, and history and laterality of OM. Intraoperatively, site of NLDO and recovery of fluorescein were recorded. Success of the probing was determined by follow-up interview 6 months post-operatively. Results: 175 NLDO of 126 patients were enrolled and 106 NLDO of 74 patients have completed 6 months follow-up. All patients will have completed 6 months of follow-up by March 2003. Overall success of initial P&I was 89.2%. Patients with OM did not have a statistically significant decrease in success of P&I (p=1.00, RR 0.974, CI 0.831-1.138 by Yates-corrected chi-square). The failure rate of 4.6% for initial P&I was equal regardless of fluorescein recovery. NLDO occurred most frequently at the valve of Hasner (45.8%). Conclusions: We did not find a statistically significant effect of OM on success of initial P&I for NLDO. Successful fluorescein recovery may not be correlated with success of P&I. 54.2% of the obstructions in our patients were noted superior to the valve of Hasner. OM was not a risk factor for initial P&I failure. Omission of fluorescein irrigation may not affect outcome and could save time and cost. References: 1. Robb RM. Probing and irrigation for congenital nasolacrimal duct obstruction. Arch Ophthalmol 1986;104:378-379. 2. Ugurbas SH, Guler Z, Saatci M. Otolaryngological findings in congenital nasolacrimal duct obstruction and implications for prognosis. Br J Ophthalmol 2000;84:917-918.

Keywords: lacrimal gland • clinical (human) or epidemiologic studies: out