Connatal dacryostenoses. Clinical picture and treatment

Connatal dacryostenosis involves obstructions of the lacrimal passages in all parts of the system as well as supernumerary structures like the connatal fistula of the lacrimal sac. Usually intervention in infants with aplasia of the puncta is not necessary. When the lacrimal passages are involved in coloboma of the lids or facial cleft, reconstruction depends on the usable tissue of the lacrimal system. Treatment of connatal mucocele consists of digital expression of the pseudo-tumor. In cases of connatal dacryostenosis due to Hasner's membrane in infants, massage of the lacrimal sac as well as application of antibiotic eye drops and detumescent nose drops is indicated. After 5 or 6 months high-pressure irrigation with the hollow probe of Bangerter is necessary. Important is the postoperative treatment with detumescent and antibiotic eye drops as well as with detumescent nose drops for 1-2 weeks. In acute inflammation, treatment of the inflammation is the first goal of therapy, which may be combined with incision of the abscess. This can be performed by transcutaneous incision as well as by endonasal intervention in cooperation with a rhinologist.