Effect of inferior turbinate infracture on outcomes of probing for congenital nasolacrimal duct obstruction.

BACKGROUND

Published reports, all of which are underpowered to detect a difference, demonstrate conflicting findings on the benefit of inferior turbinate infracture during congenital nasolacrimal duct (CNLD) probing. The purpose of this study was to report the effect of inferior turbinate infracture on outcomes of CNLD probing and assess for long-term complications from the procedure.

METHODS

The medical records of all patients <6 years of age who underwent probing for congenital nasolacrimal duct obstruction (CNLDO) at a single referral center from January 1, 2002, through December 31, 2018, were retrospectively reviewed.

RESULTS

Of 987 consecutive probing procedures, 184 (18.6%) underwent inferior turbinate infracture. The mean age at diagnosis and surgery, prevalence of prematurity, race, and sex did not differ between the infracture and control groups. Probing success was similar between infracture (80.4%) and control (80.6%) groups (P = 0.916). The subsequent development of long-term nasopharyngeal disorders including sleep apnea, chronic rhinitis, and chronic sinusitis was no different between groups. Subgroup analysis comparing outcomes of first-time probing versus first-time probing with infracture and single-surgeon analysis maintained no significant difference in outcomes between the two groups. Only late probings (age ≥24 months) tended to be more successful (but not significantly so; P = 0.16) when combined with an infracture (87.3%) compared with those without infracture (78.8%).

CONCLUSIONS

Concurrent inferior turbinate infracture did not significantly improve probing success for children with CNLDO in this cohort. However, because potential nasopharyngeal complications are unlikely, the procedure may safely be considered. Future studies should clarify the benefit of infracture for children ≥24 months of age.