Canaliculorhinostomy—Indications and Surgical Results

Abstract

To report the surgical results of canaliculorhinostomy for patients with distal canalicular obstruction and lacking a structurally functional lacrimal sac who would otherwise require a conjunctivodacryocystorhinostomy (CDCR) with Jones tube placement. Retrospective observational case series. Setting: Single tertiary institution. November 1994 to June 2011. Sixteen patients with canalicular obstruction at or beyond 8mm from the punctum, with an absent or unidentifiable lacrimal sac. Patients underwent canaliculorhinostomy, whereby direct anastomosis of the canaliculi or common canaliculus to the nasal mucosa was performed. Anatomic and functional success. Our study comprised 16 patients with a mean age of 44.9 ± 21.9 years. Ten (62.5%) were female and 6 (37.5%) male. Mean duration of follow-up was 7.8 years. Causes of an absent or unidentifiable lacrimal sac included previous trauma (n= 8, 50.0%), previous dacryocystorhinostomy (n= 4, 25.0%), chronic dacryocystitis (n= 3, 18.8%), and previous dacryocystectomy (n= 1, 6.2%). Anastomoses between the upper and lower canaliculi and the nasal mucosa was performed in 6 patients, while that between the common canaliculus and nasal mucosa was performed in 10. Anatomic and functional success rates were 87.5% (n= 14) and 81.3% (n= 13), respectively. Canaliculorhinostomy has reasonable success rates and provides an effective surgical alternative for a group of patients in whom CDCR with Jones tube placement would otherwise have been indicated.