Endonasal dacryocystorhinostomy in a pediatric patient with ectrodactyly-ectodermal dysplasia after failure of external dacryocystorhinostomy and as first procedure

A 9-year-old patient affected by ectrodactyly-ectodermal dysplasia was referred to our clinic complaining of epiphora in both eyes. She had previous external dacryocystorhinostomy in her left eye. Ophthalmic examination revealed absence of the superior tear ducts and discharge in both eyes. Lacrimal irrigation through the inferior canaliculi revealed nasolacrimal duct obstruction on both sides. A bilateral endo-dacryocystorhinostomy was performed as a revision procedure in the left eye and as first procedure in the right eye. A monocanalicular silicone stent through the inferior tear duct was introduced on both sides at the end of the surgery. Follow up was 8 and 5 months for the left and the right eye, respectively. Epiphora was absent, and lacrimal irrigation showed a patent osteum at last follow-up. This case suggests that endo-dacryocystorhinostomy seems to be a safe and effective procedure, both as revision and as first procedure, even in children with ectrodactyly-ectodermal dysplasia.