Hasner Valve Fenestration - A simpler alternative to endoscopic dacryocystorhinostomy in treating persistent epiphora in children
DOI:
https://doi.org/10.34631/sporl.378Keywords:
Congenital nasolacrimal duct obstruction, epiphora, endoscopic dacryocystorhinostomy, Hasner valveAbstract
Objective: to describe the surgical technique used by the authors to resolve congenital obstruction of the nasolacrimal duct in children - endoscopic fenestration of the Hasner valve. Casuistic, rate of success and complications are presented.
Methods: 6 children, aged between 2 and 4 years old, with history of persistent epiphora and recurrent dacryocystitis due to congenital obstruction of the nasolacrimal duct resistant to conservative treatment and probing, eventually operated during 2013 e 2014.
Technique: after endonasal endoscopic identification of the imperforated Hasner valve in the inferior meatus, the imperforate membrane is opened using a Rosen round knife. Then one of the lacrimal canaliculus is probed and the lacrimal pathway is irrigated confirming its patency.
Results: success was obtained in all 6 cases, confirmed during surgery and by resolution of the symptoms. No complications were observed.
Conclusion: external or endonasal dacryocystorhinostomy is the standard technique for the treatment of persistent epiphora resistant to probing. The authors present an alternative technique to these more invasive procedures, which appears to be an equally effective option, but simpler and safer.
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