The Role of Inferior Turbinate Fracture in the Management of Congenital Nasolacrimal Duct Obstruction

Purpose: To evaluate the effect of inferior turbinate fracture in the treatment of congenital nasolacrimal obstruction combined with first attempt probing in children younger than 36 months. Methods: This prospective case control study was conducted on 230 eyes from 176 children aged 12 to 36 months with congenital NLDO. All patients underwent simple probing under general anesthesia. Inferior turbinate fracture was performed in case group combined with first probing. Patients were followed 1,3 and 6 months after surgery. Results: Total success rate was 91.2% for patients with turbinate fracture and 86.4% for patients without turbinate fracture. The difference between success rates was not statistically significant (p value=0.269). We did not find significant difference between cases and controls in age subgroups. Success rate in combined case and control groups in patients younger than 24 months (success rate 91.7%) was significantly higher than those older than 24 months (success rate 71.9%; p value 0.001). In univariate logistic regression analysis age ≥24 months showed a negative association with the success rate (OR= 0.232, CI 95% [0.91-0.59]; p value=0.002). Other factors like sex, bilaterality of NLDO, method of probing were not significantly associated with response to treatment. Conclusion: Inferior turbinate farcture does not improve the outcomes of simple probing and is not recommended during the first attempt in treatment of congenital NLDO. Late probing (after 24 months of age) may have a higher failure rate and increased age is the important factor that predicts failure in probing simple congenital NLDO.