The Relationship Between Congenital Nasolacrimal Duct Obstruction and Mode of Delivery

Abstract

Objective: To investigate relationship between incidence of congenital nasolacrimal duct obstruction (CNLDO) and mode of delivery.

Material and Methods: Patients with epiphora, diagnosed as CNLDO in 2014-2017 years were enrolled the study. Demographic and clinical properties of the patients were identified and patients were divided into two groups according to mode of delivery, as cesarean section delivery (CSD) and normal vaginal delivery (NVD). Frequency of CNLDO, gender and laterality were compared between groups.

Results: Seventy five eyes of sixty two patients with mean age 5.5±4.6 months were included in the study. Of the patients included in the study; mode of delivery was NVD in 59.7% of the patients and CSD in 40.3% of the patients. There was no statistically significant difference between two groups according to age and laterality (p=0.501 and p= 0.624). There was no difference between mode of delivery (CSD or NVD) and incidence of CNLDO (p=0.128).

Conclusion: There was no difference between mode of delivery and frequency of CNLDO in our study, however the role of CSD in the etiopathogenesis of CNLDO is still controversial according to the literature.

Keywords

• Mode of delivery
• Epiphora
• Congenital nasolacrimal duct obstruction
• Congenital dacryostenosis

Konjenital Nazolakrimal Kanal Tıkanıklığının Doğum Şekliyle İlişkisi

Abstract

Amaç: Konjenital nazolakrimal kanal tıkanıklığı (KNLKT) görülme insidansı ile doğum şekli arasındaki ilişkiyi incelemektir.

Gereç ve Yöntemler: Çalışmaya 2014-2017 yılları arasında epifora şikayetiyle başvuran KNLKT tanısı alan hastalar dahil edildi. Hastaların demografik ve klinik özellikleri belirlendi ve hastalar doğum şekline göre sezaryen doğum (SD) veya normal vajinal yolla doğum (NVD) olarak iki gruba ayrıldı. KNLKT görülme sıklığı, cinsiyet ve lateralite özellikleri gruplar arasında karşılaştırıldı.

Bulgular: Çalışmaya başvuru yaşı ortalama 5.5±4.6 ay olan 62 hastanın 75 gözü dahil edildi. Çalışmaya dahil edilen hastaların doğum şekli %59.7’sinde NVD iken %40.3’ünde sezaryendi doğumdu. Hastaneye başvuru yaşı ve lateralite açısından gruplar arasında istatistiksel olarak anlamlı fark bulunmamaktaydı (p=0.501 ve p=0.624). Doğum şeklinin NVD ya da SD olması ile KNLKT görülme sıklığı arasında farklılık yoktu (p=0.128).

Sonuç: Çalışmamızda doğum şekli ile KNLKT görülme sıklığı arasında farklılık tespit edilmemiştir ancak sezaryen doğumun KNLKT için artmış bir risk faktörü olarak etyopatogenezdeki rolü literatürde tartışmalı olarak devam etmektedir.

Keywords

• Konjenital nazolakrimal kanal tıkanıklığı
• Konjenital dakriyostenoz
• Epifora
• Doğum şekli

References

1. 1. MacEwen CJ, Young JD. Epiphora during the first year of life. Eye (Lond)1991;5:596-600.
2. 2. Sathiamoorthi S, Frank RD, Mohney BG. Incidence and clinical characteristics of congenital nasolacrimal duct obstruction. Br J Ophthalmol 2019103:527-9
3. 3. Aldahash FD, Al-Mubarak MF, Alenizi SH, Al-Faky YH. Risk factors for developing congenital nasolacrimal duct obstruction. Saudi J Ophthalmol 2014;28:58-60.
4. 4. Kashkouli MB, Sadeghipour A, Kaghazkanani R, Bayat A, Pakdel F, Aghai GH. Pathogenesis of primary acquired nasolacrimal duct obstruction. Orbit 2010;29:11-5.
5. 5. Bekmez S, Eriş E, Altan EV, Dursun V. The Role of Bacterial Etiology in the Tear Duct Infections Secondary to Congenital Nasolacrimal Duct Obstructions. J Craniofac Surg 2019;30:2214-6.
6. 6. Ali MJ. Pediatric Acute Dacryocystitis. Ophthalmic Plast Reconstr Surg 2015;31:341-7.
7. 7. Matta NS, Singman EL, Silbert DI. Prevalence of amblyopia risk factors in congenital nasolacrimal duct obstruction. J AAPOS 2010;14:386-8.
8. 8. Eshraghi B, Akbari MR, Fard MA, Shahsanaei A, Assari R, Mirmohammadsadeghi A. The prevalence of amblyogenic factors in children with persistent congenital nasolacrimal duct obstruction. Graefes Arch Clin Exp Ophthalmol 2014;252:1847-52.

9. 9. Cassady JV. Developmental anatomy of nasolacrimal duct. AMA Arch Ophthalmol 1952;47:141-58.
10. 10. Young JD, MacEwen CJ. Managing congenital lacrimal obstruction in general practice. BMJ 1997;315:293-6.
11. 11. Petersen RA, Robb RM. The natural course of congenital obstruction of the nasolacrimal duct. J Pediatr Ophthalmol Strabismus 1978;15:246-50.
12. 12. Pediatric Eye Disease Investigator Group. Resolution of congenital nasolacrimal duct obstruction with nonsurgical management. Arch Ophthalmol 2012;130:730-4.
13. 13. Świerczyńska M, Tobiczyk E, Rodak P, Barchanowska D, Filipek E. Success rates of probing for congenital nasolacrimal duct obstruction at various ages. BMC Ophthalmol 2020;20:403.
14. 14. MacEwen CJ, Young JD, Barras CW, Ram B, White PS. Value of nasal endoscopy and probing in the diagnosis and management of children with congenital epiphora. Br J Ophthalmol 2001;85:314-8.
15. 15. Lorena SH, Silva JA, Scarpi MJ. Congenital nasolacrimal duct obstruction in premature children. J Pediatr Ophthalmol Strabismus 2013;50:239-44.
16. 16. Tavakoli M, Osigian CJ, Saksiriwutto P, Reyes-Capo DP, Choi CJ, Vanner EA, et al. Association between congenital nasolacrimal duct obstruction and mode of delivery at birth. J AAPOS 2018;22:381-5.
17. 17. Kuhli-Hattenbach C, Lüchtenberg M, Hofmann C, Kohnen T. Erhöhte Prävalenz konnataler Tränenwegsstenosen nach Sectio caesarea [Increased prevalence of congenital dacryostenosis following cesarean section]. Ophthalmologe 2016;113:675-83.
18. 18. Dolar Bilge A. Mode of delivery, birth weight and the incidence of congenital nasolacrimal duct obstruction. Int J Ophthalmol 2019;12:1134-8.
19. 19. Spaniol K, Stupp T, Melcher C, Beheiri N, Eter N, Prokosch V. Association between congenital nasolacrimal duct obstruction and delivery by cesarean section. Am J Perinatol 2015;32:271-6.
20. 20. Alakus MF, Dag U, Balsak S, Erdem S, Oncul H, Akgol S, et al. Is there an association between congenital nasolacrimal duct obstruction and cesarean delivery? Eur J Ophthalmol 2020;30:1228-31.
21. 21. Palo M, Gupta S, Naik MN, Ali MJ. Congenital Nasolacrimal Duct Obstruction and Its Association With the Mode of Birth. J Pediatr Ophthalmol Strabismus 2018;55:266-8.
22. 22. Yildiz A. Congenital nasolacrimal duct obstruction: caesarean section vs. vaginal delivery. Med Glas (Zenica) 2018;15:164-7.
23. 23. Olitsky SE. Update on congenital nasolacrimal duct obstruction. Int Ophthalmol Clin 2014;54:1-7.