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The Role of Inferior Turbinate Fracture in the Management of Congenital Nasolacrimal Duct Obstruction

Rajabi, Mohammad Taher, M.D.; Inanloo, Bahman, M.D.; Salabati, Mirataollah, M.D.; Rafizadeh, Mohsen, M.D.; Tabatabaie, Seyed Ziaeddin, M.D.; Bayat, Reza, M.D.; Mahmoudzadeh, Raziyeh, M.D.

Ophthalmic Plastic & Reconstructive Surgery: May/June 2019 - Volume 35 - Issue 3 - p 269–271
doi: 10.1097/IOP.0000000000001228
Original Investigations
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Purpose: To evaluate the effect of inferior turbinate fracture in the treatment of congenital nasolacrimal obstruction combined with first attempt probing in children younger than 36 months.

Methods: This prospective case–control study was conducted on 230 eyes from 176 children aged 12 to 36 months with congenital nasolacrimal duct obstruction. All patients underwent simple probing under general anesthesia. Inferior turbinate fracture was performed in case group combined with first probing. Patients were followed up 1, 3, and 6 months after surgery.

Results: Total success rate was 91.2% for patients with turbinate fracture and 86.4% for patients without turbinate fracture. The difference between success rates was not statistically significant (p = 0.269). The authors did not find significant difference between cases and controls in age subgroups. Success rate in combined case and control groups in patients younger than 24 months (success rate: 91.7%) was significantly higher than those older than 24 months (success rate: 71.9%; p = 0.001). In univariate logistic regression analysis, age ≥24 months showed a negative association with the success rate (odds ratio = 0.232; 95% confidence interval: 0.91–0.59; p = 0.002). Other factors like sex, bilaterality of nasolacrimal duct obstruction, method of probing were not significantly associated with response to treatment.

Conclusions: Inferior turbinate fracture does not improve the outcomes of simple probing and is not recommended during the first attempt in treatment of congenital nasolacrimal duct obstruction. Late probing (after 24 months of age) may have a higher failure rate, and increased age is the important factor that predicts failure in probing simple congenital nasolacrimal duct obstruction.

Inferior turbinate fracture does not increase the success rate of simple probing as a first attempt and is not recommended. Probing after 24 months of age has a higher failure rate than early probing.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Accepted for publication July 27, 2018.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Raziyeh Mahmoudzadeh, M.D., Farabi Eye Hospital, Ghazvin square, Tehran, Iran. E-mail: razieh.mah@gmail.com

© 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.