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Therapie von Canaliculus-communis-Stenosen mittels Ballonkatheterdilatation

Balloon dilatation of the canaliculus communis for chronic epiphora

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Zusammenfassung

Ziel

Untersuchung der klinischen Effizienz der Dakryozystoplastie bei Obstruktionen des Canaliculus communis.

Material und Methode

Insgesamt 18 Tränenapparate wurden bei durch Dakryozystographie (DCG) nachgewiesener höhergradiger Stenose des Canaliculus communis mittels Ballonkatheterdilatation in Lokalanästhesie elektiv behandelt.

Ergebnisse

Bei 16/18 Tränenapparaten war die Ballonkatheterdilatation technisch erfolgreich. In 2 Fällen war eine Sondierung mittels Führungsdraht nicht möglich. Es kam zu keinen eingriffsbedingten Komplikationen. Über eine mittlere Beobachtungszeit von 9 Monaten war die Ballonkatheterdilatation bei 14/18 Tränenapparaten klinisch erfolgreich, 11/18 Fälle waren nach Ballonkatheterdilatation beschwerdefrei, bei 3/18 Fällen kam es zu einer Befundbesserung.

Schlussfolgerung

Bei Canaliculus-communis-Stenosen stellt neben der Kanalikulodakryozystorhinostomie die Implantation eines Silikonschlauches die bevorzugte Therapieoption dar. Die Ergebnisse beider Verfahren waren jedoch oft enttäuschend. Die Ballonkatheterdilatation ist eine in Lokalanästhesie durchgeführte minimal-invasive Technik, die zunehmend eine alternative Therapieoption zur Behandlung präsakkaler Stenosen darstellt.

Abstract

Purpose

To examine the clinical outcome of the balloon dilatation in stenosis of the canaliculus communis.

Method

18 nasolacrimal ducts with epiphora and proven obstruction of the canaliculus communis by dacryocystography (DCG) were treated with balloon dilatation in local anaesthesia. All patients were treated electively.

Results

In 16/18 cases the balloon dilatation was technically successful, in 2 patients the guide wire failed to pass the obstruction and the wire could not be placed in the nasal cavity. There were no complications. Over a mean follow-up of 6 months there were 2 reobstructions, one of these led to an occlusion of the canaliculus communis. 14/18 (77,8%) cases after DCP were treated successful, 11/18 cases were free of symptoms after DCP, in 4/18 cases the epiphora improved.

Conclusions

Until recently in stenosis of the canaliculus communis the only therapeutic option was surgical procedure followed by silicone tube intubation. The results were often disappointing. In contrast to this balloon dacryocystoplasty is a minimally-invasive alternative in the therapy of stenosis of the canaliculus communis resulting in good clinical outcome during follow up.

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Authors and Affiliations

  1. Augenklinik, Kantonsspital St. Gallen, Schweiz

    U. Lachmund & D. Ammann

  2. Augenklinik, Kantonsspital Aarau, Schweiz

    U. Lachmund & A. Forrer

  3. Institut für Radiologie, Kantonspital Bruderholz, Schweiz

    U. Lachmund & C. Petralli

  4. Institut für Diagnostische und Interventionelle Neuroradiologie, Inselspital, Bern, Schweiz

    L. Remonda

  5. Institut für Radiologie, Kantonsspital Aarau, Schweiz

    U. Lachmund & T. Roeren

  6. Vista Klinik, Binningen, Schweiz

    F. Vonmoos

  7. Radiologische Universitätsklinik, Rheinische Friedrich-Wilhelms-Universität Bonn, Deutschland

    K. Wilhelm

  8. Augenklinik, Kantonsspital St. Gallen, 9007 , St. Gallen, Schweiz

    U. Lachmund

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  1. U. Lachmund
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  2. D. Ammann
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  8. K. Wilhelm
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Correspondence to U. Lachmund.

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Lachmund, U., Ammann, D., Forrer, A. et al. Therapie von Canaliculus-communis-Stenosen mittels Ballonkatheterdilatation. Ophthalmologe 102, 369–374 (2005). https://doi.org/10.1007/s00347-004-1112-3

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  • DOI: https://doi.org/10.1007/s00347-004-1112-3

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