Congenital nasolacrimal duct obstruction in patients with craniofacial abnormalities
Reviewed by Hetvi Bhatt

This is a retrospective study including 1998 patients over a period of 10 years. Of this number, 41 patients were identified as having a craniofacial abnormality and congenital nasolacrimal duct obstruction (CNLDO) (23.1 per 10,000 live births). Interestingly the most common craniofacial syndrome is documented as “syndrome suspected” with the second most common being Trismony 21. Including the group “syndrome suspected” could introduce bias to the data and the authors may have considered excluding this group due to lack of information. The authors report that 31.7% of CNLDO in the craniofacial cohort required probing and no patients in this group required dacryocystorhinostomy (DCR). Although the rate of probing is significantly higher compared to the non-craniofacial cohort, it is interesting that no patients required DCR. The authors conclude that CNLDO in a craniofacial cohort often presents later (6.2 months vs 3.7 months, p=0.035) and has increased odds of requiring intervention but continuing with watchful waiting up to one year of age is still a reasonable approach.

Incidence and clinical characteristics of congenital nasolacrimal duct obstruction with concurrent craniofacial abnormalities among a population-based cohort.
Ashby G, Mohney BG, Wagner LH.
ORBIT
2024;43(5):583–7.