Congenital nasolacrimal duct obstruction in trisomy 21 vs non-trisomy 21 patients
Reviewed by Hetvi Bhatt

This is a retrospective case review study looking at patients who underwent intervention for congenital nasolacrimal duct obstruction (CNLDO) between January 2017 and January 2018. The authors state that patients were excluded if there was less than 60 months of follow-up data, however it is worth noting that this is potential follow-up (as quoted in the article) and that 87.1% of the cohort had been discharged within that time period. There were three stages of intervention: (1) syringe and probing, (2) stenting, (3) dacryocystorhinostomy (DCR). Only 8.8% of patient progressed to requiring DCR. Forty-nine of 93 cases were bilateral. Interestingly, 81.8% of CNLDO cases in trisomy 21 were bilateral which is significantly higher than the non-trisomy 21 group (50%). The authors found no difference in success from insertion of stent in the presence or absence of an ENT surgeon. Another interesting observation was that the mean age at first intervention was 40.22 ±28.52 months. Sixty-three-point-six percent of patients required stenting after primary syringe and probing and the authors have therefore advocated that stenting be considered as the primary intervention to reduce the number of general anaesthetics a child will undergo.

Management and outcomes of congenital nasolacrimal duct obstruction in trisomy 21 patients vs. non-trisomy 21 patients within a paediatric population: a 5-year follow-up.
Fenech MT, Raj A, Dodeja R, et al.
ORBIT
2025;44(1):10–7.