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Newborn dacryocystitis
Last reviewed: 23.04.2024
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[What causes dacryocystitis in newborns?
The main cause of development of newborns' dacryocystitis is that at the time of birth the nose of the nasolacrimal duct, which ends in a blind bag, does not open (due to the developmental malformation).
In children, diseases of the tear ducts are often the cause of chronic conjunctivitis, phlegmon of the lacrimal sac and orbits, corneal lesions, septicopyemia, etc. Untreated dacryocystitis gradually leads to irreversible anatomical changes in the lacrimal ways, which eventually exclude the success of conservative treatment.
Symptoms of dacryocystitis in a newborn child
A few days after birth, there is an insignificant discharge of mucopurulent contents from the conjunctival sac. In this case, the conjunctiva is hyperemic. When pressing on the area of the lacrimal sac of lacrimal points, its contents are isolated. Dacryocystitis of a newborn can lead to the development of true dacryocystitis with the release of purulent contents, but more often the disease ends safely, since the membrane that closes the exit from the lacrimal ways is restored.
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Treatment of newborn dacryocystitis
Treatment of dacryocystitis of the newly initiated is recommended to begin with vigorous massage of the lacrimal sac outside the inner corner of the eye slit from top to bottom. From a jerky pressure on the contents of the lacrimal sac, the membrane that closes the exit from the nasolacrimal duct is ruptured, and the patency of the tear ducts is restored.
To prevent infection of the contents of the lacrimal sac, it is recommended to instill a 20% solution of albucid or penicillin into the coion-active bag.
In the absence of a positive effect of massage in the case of dacryocystitis, the newly born go to endonasal retrograde probing, which must begin at the age of two months. Without preliminary anesthesia under the control of vision, the surgical probe probe, bent at the end at a right angle, is inserted along the bottom of the nasal cavity to half the length of the lower nasal passage. When the button probe is removed, the bent end of the probe is pressed tightly against the arch of the lower nasal passage and the obstruction in the mouth of the nasolacrimal duct is perforated, then the probe is removed. After probing, the lacrimal tracts are washed with antibiotic solution. This speeds up the process of restoring normal lachrymation. In the absence of effect, repeated soundings are carried out at intervals of 5-7 days. Three-time sounding is justified up to 6 months of age. The absence of the effect of retrograde sounding makes it necessary to go on to the treatment by probing outside with Bowman's probe No. 0 or No. 1. After dilating the lacrimal point, the cone probe horizontally inserts Bowman's probe along the tubule into the sac, then transfers it to the vertical position and moves down the nasolacrimal duct, perforating the lower its part is not dissipated by the time of the birth of the membrane. In the absence of effect and from this treatment, children over 2 years of age are given dacryocystorhinostomy