Endoscopic management of pediatric nasolacrimal anomalies

Developmental anomalies of the nasolacrimal drainage system typically manifest early in childhood with epiphora and occasionally infection. Although the majority of cases of congenital nasolacrimal obstruction resolve spontaneously with conservative medical management, certain anomalies require operative intervention. Included in this latter group are dacryocystoceles or nasolacrimal duct cysts. The application of endoscopic sinus surgical techniques to children with persistent symptomatic nasolacrimal obstruction provides an alternative to external dacryocystorhinostomy that appears to be equally efficacious and concurrently allows for the potential correction of any predisposing intranasal pathology. Endonasal endoscopic dacryocystorhinostomy is best performed as a joint otolaryngologic-ophthalmologic procedure.