title: [Endoscopy of the Lacrimal Duct System in Children].
abstract: BACKGROUND
  Pathologies of the lacrimal duct system show a frequent occurrence in paediatric ophthalmology. Mostly, the connection between the nasolacrimal duct and the nose fails to open but also combined diseases or congenital anomalies may be the reason. Because of complications, the chance for healing after a conservative therapeutic approach decreases and surgical intervention is necessary.
  
  
  METHODS
  The opportunity for transcanalicular endoscopy of the lacrimal duct system in children is shown by the presentation of three different case reports. Typical clinical findings are given and the use of dacryoendoscopy for diagnostic and therapeutic benefit is pointed out. Therefore, we present an 8-week-old child, suffering recurrent purulent inflammation due to an amniotocele (1), a 5-year-old child having a congenital lacrimal fistula (2) and another 5-year-old child with a severe chronic dacryocystitis of both eyes after several lacrimal duct surgeries showing remaining intrasaccal silicone tubes (3).
  
  
  RESULTS
  In all these cases transcanalicular endoscopy could be used successfully for reconstruction of the lacrimal duct systems. A bullous Hasner's membrane could be localized and opened (1). The lacrimal fistula was identified to communicate with the common canaliculus and combined stenosis of the canaliculus and saccus were treated (2). In the third case fragments of intrasaccal silicone tubes could be localised and the foreign bodies could be evacuated by transcanalicular surgery (3). The children with lacrimal fistula and the intrasaccal foreign bodies were treated with self-threading silicone tubing which was removed three months later. In the follow-up period (16 months in case 2, 22 months in case 3 and 38 months in case 1) recurrences of the lacrimal pathologies or clinical complaints were absent.
  
  
  CONCLUSIONS
  Transcanalicular endoscopy of the lacrimal duct system should not be regarded as the means of choice but it does offer additional diagnostic and therapeutic options for special indications. A main advantage of this kind of surgery is its minimally invasive character. Under visual control, topographic anatomy can be preserved. Dacryoendoscopy in children should be done only by experienced surgeons.
authors: Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale.
authors: J
authors: J
authors: Heichel
authors: Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale.
authors: T
authors: T
authors: Bredehorn-Mayr
authors: Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale.
authors: H-G
authors: HG
authors: Struck
mesh_terms: D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000379:methods; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007223:Infant; D007765:Lacrimal Apparatus / Q000473:pathology* / Q000601:surgery*; D007766:Lacrimal Apparatus Diseases / Q000473:pathology* / Q000601:surgery*; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome