Comparative Analysis of Silicone Tube Intubation Versus Probing and Balloon Dilation for Congenital Nasolacrimal Duct Obstruction: A Systematic Review and Meta-Analysis.

Autor:	Alruwaili R; Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh.; Department of Ophthalmology, King Abdulaziz Specialist Hospital., Alanazi F; Department of Otolaryngology-Head and Neck Surgery, Prince Mohammed Medical City, Jouf., Alrashidi A; Department of Otolaryngology-Head and Neck Surgery, King Salman Specialist Hospital, Hail., Hazazi M; Department of Otolaryngology-Head and Neck Surgery, Prince Sultan Medical Military City, Riyadh., Alenezi M; Department of Otolaryngology-Head and Neck Surgery, Collage of Medicine, Qassim University, Buriyadh, Qassim, Kingdom of Saudi Arabia.
Jazyk:	angličtina
Zdroj:	The Journal of craniofacial surgery [J Craniofac Surg] 2024 Jun 01; Vol. 35 (4), pp. 1114-1119. Date of Electronic Publication: 2024 May 10.
DOI:	10.1097/SCS.0000000000010273
Abstrakt:	Objective: Congenital nasolacrimal duct obstruction (CNLDO) is a pediatric disorder with a wide range of pathology. If untreated, the condition may end up with serious complications. Multiple treatment options for CNLDO exist throughout the literature, and there is an ongoing debate on the best intervention for each disease subgroup and the best timing of such interventions. This study compares the success and failure rates of silicone tube intubation (STI) against probing and balloon dilation (BD). Methods: The authors searched the literature for relevant articles using PubMed, Scopus, web of Science, and Cochrane Library until January 2024. Using RevMan 5.4, the authors compared STI's success and failure rates to probing and BD using risk ratios (RRs) and a random-effect model. In addition, the complication rate of monocanalicular intubation (MCI) versus bicanalicular intubation (BCI) was investigated. The authors used the leave-one-out method to check for influential studies and to resolve heterogeneity. Results: The screening process resulted in 23 eligible articles for inclusion in the authors' review. Silicone tube intubation had a higher chance of resolving the symptoms of CNLDO than probing (RR = 1.11; 95% CI: 1.04, 1.20; P = 0.004) while having less risk of surgical failure (RR = 0.48; 95% CI: 0.30, 0.76; P = 0.002]. Monocanalicular intubation showed no statistically significant difference when compared with BCI in terms of surgical success and failure; however, MCI had a lower risk of complications (RR = 0.68; 95% CI: 0.48, 0.97; P = 0.04). In addition, STI did not demonstrate any significant difference from BD. Conclusion: There was no significant difference in success/failure between MCI and BCI; monocanalicular had fewer complications. Silicone tube intubation did better in terms of surgical success than probing, especially in children over 12 months, suggesting that it is the preferred intervention for older patients with CNLDO. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 by Mutaz B. Habal, MD.)
Databáze:	MEDLINE
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