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- W4387405107 abstract "Pediatric dacryocystorhinostomy (DCR) has its own set of challenges owing to the narrow anatomical confines, mobility of instruments, the proximity of various critical structures, and aggressive postoperative healing [1–5]. Narrower nasal cavities warrant the use of pediatric instruments. Due to variations in the lateral wall anatomy and the presence of a lower skull base, the bony osteotomy should be performed carefully to obtain satisfactory ostia. Septoplasty is mostly avoided in pediatric patients due to concerns about functional disruptions of the facial growth zones. The deviated nasal septum in this age group usually does not present a significant challenge during endonasal DCRs. However, there are exceptional situations like post-trauma or certain syndromic congenital nasolacrimal duct obstructions (CNLDO), where a limited septoplasty may be needed, which entails strictly following certain guidelines by the surgeons [1]. While achieving good hemostasis in narrower nasal cavities is challenging and may influence outcomes and an uneventful surgery, anesthetist consultation in the judicious use of decongestants is advised. Besides, an option of total intravenous anesthesia, as used in pediatric sinus surgeries, may be explored. A major systematic review of 14 studies on exclusive pediatric endoscopic DCR with an average follow-up of 15 months has shown that the mean (95% CI) rate of success was 0.87 (0.80–0.91) and the mean (95% CI) failure rate was 0.14 (0.09–0.21) [2]. The outcomes of endoscopic DCR in pediatric population are comparable to that of an external DCR [6, 7]." @default.
- W4387405107 created "2023-10-07" @default.
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- W4387405107 date "2023-01-01" @default.
- W4387405107 modified "2023-10-07" @default.
- W4387405107 title "Pediatric Dacryocystorhinostomy" @default.
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- W4387405107 doi "https://doi.org/10.1007/978-981-99-1401-2_64-1" @default.
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