H G Struck1, D Horix, D Ehrich. 1. Universitäts-Augenklinik der Martin-Luther-Universität Halle-Wittenberg. hans-gert.struck@medizin.uni-halle.de
Abstract
BACKGROUND: Canalicular lacerations can be the result of sharp or blunt trauma as well as burns of the facial region. The nasolacrimal duct may become obstructed as an after-effect of naso-orbital trauma. MATERIAL AND METHODS: Main principles of surgical repair of the lacrimal system are reviewed with regard to the outcome of our own patients compared with the literature. RESULTS: Success rates in the primary repair of traumatic injuries of canalicular system are about 70 to 82 %. 14 of 20 patients who were managed between 1976 and 1980 in our department were cured permanently. 55 of 272 secondary reconstructions of canalicular obstructions (1976 - 1997) were caused by trauma. Conjunctivodacryocystorhinostomy with polyethylene or silicone tubes (1978 - 1999, n = 37, 21 traumatic) had success rates of 61 % and 72 %, respectively. 11 (4.8 %) of 228 dacryocystorhinostomies (1991 - 2000) were necessary as a result of traumatic injuries and achieved a success rate of 87.5 %. CONCLUSIONS: Canalicular lacerations need urgent primary repair with silicone intubation and special heed to the medial canthal tendon. The success rate of secondary reconstructions of traumatically caused tear-duct system obstructions depends on the microsurgical techniques that were used.
BACKGROUND: Canalicular lacerations can be the result of sharp or blunt trauma as well as burns of the facial region. The nasolacrimal duct may become obstructed as an after-effect of naso-orbital trauma. MATERIAL AND METHODS: Main principles of surgical repair of the lacrimal system are reviewed with regard to the outcome of our own patients compared with the literature. RESULTS: Success rates in the primary repair of traumatic injuries of canalicular system are about 70 to 82 %. 14 of 20 patients who were managed between 1976 and 1980 in our department were cured permanently. 55 of 272 secondary reconstructions of canalicular obstructions (1976 - 1997) were caused by trauma. Conjunctivodacryocystorhinostomy with polyethylene or silicone tubes (1978 - 1999, n = 37, 21 traumatic) had success rates of 61 % and 72 %, respectively. 11 (4.8 %) of 228 dacryocystorhinostomies (1991 - 2000) were necessary as a result of traumatic injuries and achieved a success rate of 87.5 %. CONCLUSIONS: Canalicular lacerations need urgent primary repair with silicone intubation and special heed to the medial canthal tendon. The success rate of secondary reconstructions of traumatically caused tear-duct system obstructions depends on the microsurgical techniques that were used.