الفهرس 
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Abstract
Study design; Pilot randomized controlled study.
Objective: To compare success rates of endoscopic endonasal dacryocystorhinostomy and nasolacrimal duct intubation in congenital nasolacrimal duct obstruction (NLDO) in a trial to define the superiority of either technique.
Patients & Methods: Sixty-six eyes of 61 patients were diagnosed as having epiphora and mucopurulent discharge due to congenital NLDO. The patients were randomly divided into two groups; group A; 33 eyes of 28 patients (treated by probing and silicone intubation only (NLDI)) and group B; 33 eyes of 33 patients (treated by endoscopic endonasal dacryocystorhinostomy and silicone tube intubation (EDCR). All tubes were removed 6 months after the operation.
Results: The success rate, defined as complete resolution of clinical symptoms and signs after 6 months of follow up, was 72.7 % in group A and 81.8% in group B. Although the success rate was higher in group B, yet the difference was shown to be statistically non-significant. Preoperative symptoms were assessed postoperatively after tube removal. Complete cure had a higher rate of occurrence in group B than in group A (27eyes (81.8%) versus 25 eyes of 22 patients (75.8%) respectively). Postoperative positive fluorescein dye disappearance test (FDDT) after tube removal was more in group B than in group A (27 eyes (81.8) versus 24 eyes of 21 patients (72.7 %) respectively). In group A, silicone tubes had to be repositioned due to prolapse in 3 eyes of 3 patients (9.1%) and had to be removed early in 3 eyes of 3 patients (9.1%) due to failure of repositioning. In group B, silicone tubes did not require early tube extraction before the date of removal in any of the patients. Intraoperative, there was only one case (3.0%) of fat prolapse during EDCR in group B with no subsequent postoperative complications. Hemostasis did not represent a problem in any of the patients. Postoperative complications occurred more in group B than group A (21 eyes (63.6%) versus 13 eyes of 13 patients (39.4 %) respectively). Late complications occurred more in group B than group A (18 eyes (54.5%) versus 12 eyes of 12 patients (36.4%) respectively) in the form of persistent epiphora and tube prolapse.
Conclusion: The success rate of pediatric EDCR was higher than that of pediatric NLDI. The difference was statistically non-significant. Complications were comparable between the two groups. The study, being pilot in its comparative aspect between endoscopy and intubation, opens the horizon for further study on a larger group that probably will expand this difference.