Computed tomographic dacryocystography in children undergoing balloon dacryoplasty.
OBJECTIVE
To ascertain whether the volume and circumference of the lacrimal sac and nasolacrimal duct as measured by contrast-enhanced computed tomographic dacryocystography (CT-DCG) before and after balloon dacryoplasty could be used to predict clinical success in children with congenital nasolacrimal obstruction.


METHODS
Nasolacrimal ducts of children aged 2 to 6 years with clinical signs of congenital nasolacrimal duct obstruction undergoing balloon dilation were imaged with contrast-enhanced CT-DCG before and 5 minutes after the procedure. The circumference of the most dilated portion of the lacrimal sac was measured on the axial plane. The volume of contrast within the nasolacrimal duct and sac was also measured before and after the procedure. Clinical success was defined as the disappearance of signs of epiphora.


RESULTS
A total of 18 nasolacrimal ducts of 13 children were included. The average circumference of the most dilated portion of the lacrimal sac was 1.30 ± 0.45 cm (range, 0.64-2.50 cm) before the procedure. The average contrast volume was 0.12 ± 0.08 cm(3) (range, 0.01-0.38 cm(3)) before and 0.07 ± 0.06 cm(3) (range, 0.01-0.20 cm(3)) after (P = 0.01). Data were analyzed using multivariate logistic regression with a backward variable input model; a decrease in contrast volume before and after dilation (P = 0.04) was associated with clinical success, whereas the larger size of the most dilated portion of the lacrimal sac (P = 0.01) was associated with clinical failure.


CONCLUSIONS
Contrast-enhanced CT-DCG provides useful information about nasolacrimal anatomy in children with congenital nasolacrimal duct obstruction. The decrease in contrast volume before and after balloon dilation was predictive of success; A larger size of the most dilated portion of the lacrimal sac was associated with clinical failure.
Ophthalmology Reference Center at the Hospital das Clínicas of the Federal University of Goiás, Goiás, Brazil. rmurillousp@hotmail.com
Roberto M
RM
Limongi
Leopoldo
L
Magacho
Suzana
S
Matayoshi
Haroldo M
HM
Carneiro
Marcos
M
Avila
D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003608:Dacryocystorhinostomy / Q000379:methods*; D004108:Dilatation, Pathologic / Q000209:etiology / Q000601:surgery; D006801:Humans; D007472:Iohexol; D007767:Lacrimal Duct Obstruction / Q000151:congenital / Q000000981:diagnostic imaging; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol