Probing of the lacrimal canal in newborns is a serious ophthalmological operation, during which the gelatin film is removed. She does not let the tears protruding in her eyes into the nasal cavity. Usually this channel opens on its own with the first sigh and the cry of the child. However, 5% of newborns show pathology.
Medical certificate
Each baby during its fetal life has a gelatinous film on its eyes, respiratory tract and nose. It prevents the ingress of amniotic fluid, and usually bursts at birth. If this process does not occur, a plug is formed in the lacrimal canal. It interferes with the process of lacrimation. The secreted secretion does not enter the nasal canal and accumulates in the lacrimal sac. As a result, the latter can become inflamed and deformed. Propagation in this area of bacteria leads to the formation of purulent masses, and near the eye itself a swelling forms. These phenomena in medicine are known as dacryocystitis disease.
Pathology can be caused by congenital curvature of the nasal septum. This is the main, but not the only reason for the blockage of the lacrimal canal secreted by secretion and dead cells of the epithelium. Dacryocystitis is manifested by the following symptoms:
- flow of tears from the eye;
- the presence of purulent discharge;
- swelling of the eyelids;
- swelling in the eye area.
After confirming the diagnosis, the doctor prescribes treatment. In the early stages of the pathology, it comes down to massage and the use of anti-inflammatory drops. In the absence of positive dynamics, probing of the lacrimal canal is recommended. The operation is prescribed before the age of 6 months. Early treatment provides a positive effect in 85-95% of cases. After a year, the film begins to harden, which significantly complicates the therapy. Relapses often occur in older children, which requires repeated intervention.
Causes of obstruction of the lacrimal canal
Dacryocystitis is not the only reason for the development of the disorder. Among the main factors provoking blockage of the lacrimal sac, doctors distinguish:
- hereditary disorders transmitted at the gene level;
- injuries and mechanical damage;
- sinusitis, blepharitis, tuberculosis;
- obstruction due to syphilis.
If you do not consult a doctor in a timely manner, purulent discharge can spread to the second eye, infect the ear. In addition, refusal of the operation often leads to a weakening or complete loss of vision.
Preparation for the procedure
The operation is usually prescribed to infants aged 1 to 4 months. Probing the lacrimal canal in newborns does not differ from that for schoolchildren or adolescents. Before the intervention, it is necessary to show the child to the otolaryngologist. The specialist should exclude the curvature of the septum of the nose. Otherwise, the effect of the procedure will not live up to expectations.
In addition, preparatory activities include:
- Blood coagulation test.
- Analysis of the secret of the lacrimal sac.
- Pediatrician examination to identify concomitant health problems.
- Consultation with an allergist to minimize the risk of an allergic reaction to the applied anesthesia.
- Testing West. During the procedure, a colored liquid is instilled into the child’s eye, and a tampon is inserted into the nasal cavity. How seriously the canal is clogged shows the amount of fluid on the swab.
A few hours before the operation, the newborn should not be fed. It is also recommended that you swaddle your baby tightly to prevent movement during the procedure. Before probing, it is strictly forbidden to take medications that are incompatible with drugs that doctors will use.
Stages of the operation
Probing of the lacrimal canal in newborns is carried out in a hospital. The procedure itself lasts no more than 10 minutes, hospitalization after it is not required. It is performed using local anesthesia. As an anesthetic, Alkain is usually used. The operation consists of the following steps:
- The patient is laid on a couch and anesthetized drug is instilled into the eyes.
- They fix the position, the head is held by the nurse.
- A special probe is introduced into the lacrimal canal of the newborn, which helps to expand the ducts.
- Additionally, a thinner probe may be required to break through the gelatin film.
- The ducts are washed with a disinfectant.
- At the final stage, the West test is repeated.
A few hours after the end of the procedure, parents can take the small patient home. If a serious infectious lesion is detected, the baby is left in the hospital for several days until the final recovery.
Recovery period
In order to avoid complications after sensing, it is necessary to use drops with an antibiotic for some time. The name, dosage and duration of use is determined by the doctor. During the week after surgery, it is also recommended to massage the lacrimal canal. The stages of its conduct should tell the doctor at the consultation.
All the week after the intervention, slight bleeding from the nose and nasal congestion can be observed. These are quite normal phenomena and are not a cause for panic. Inflammation and tearing should disappear on their own after about 10-15 days. A child is allowed to bathe daily, but you should not forbid him to rub his eyes. If discomfort in the eye area persists for more than two weeks, additional symptoms of malaise appear, consult a doctor. Only in this case can the development of concomitant health problems be prevented.
Possible complications
Probing the lacrimal canal is a fairly simple procedure. However, it implies interference, so sometimes complications cannot be avoided. Moreover, each organism is individual and can respond to the operation in its own way.
As a rule, complications arise due to a violation of the sounding technique. A scar may form at the place where the lacrimal canal was originally punctured. Among other complications, doctors call the following:
- lacrimation
- irritation of the eyelid mucosa and the development of conjunctivitis;
- redness of the eyeball;
- purulent or cloudy secretion from under the eyelids;
- fever, chills;
- the appearance of adhesions in the lacrimal canal;
- the child becomes lethargic and moody, may refuse to eat.
How do children respond to anesthesia? According to statistics, every tenth patient has nausea and vomiting within 10 days after surgery. Only 1% of children show an allergic reaction to anesthesia.
Risks and forecasts
Many parents quite often confuse the obstruction of the lacrimal canal and conjunctivitis. Both pathologies have a similar clinical picture. At the same time, improper treatment of conjunctivitis begins, which stops symptoms only for a short time. The cause of the underlying disease is not eliminated.
The consequences of this kind of therapy are expressed in the accumulation of purulent masses, deterioration in the well-being of the child. Then the clinical picture is supplemented by severe swelling and the appearance of compaction. In a small patient, the temperature rises, he becomes restless and moody. Only an appeal to an ophthalmologist can correct the situation, determine the need for surgical intervention.
A distinctive feature of dacryocystitis is the release of pus from one or both eyes at the same time. When massage of the lacrimal canal does not bring relief, an operation is necessary. Narrowing of the lacrimal duct, the presence of chronic inflammation in this area, and profuse lacrimation are also considered an indication for sensing. As a rule, the procedure has a favorable prognosis, small patients quickly recover.
The need for re-intervention
To restore patency of the lacrimal canals in newborns, one sensing procedure is enough. However, neglect of the doctor's recommendations in the postoperative period can provoke a relapse. This phenomenon is often accompanied by an adhesion process. Repeated intervention is also recommended if after the first within 30 days there is no improvement in the condition of a small patient.
The second procedure for sensing the lacrimal canal in children is practically no different from the first. It is carried out on the same principle. In some cases, the doctor decides to insert special silicone tubes into the ducts. They prevent obstruction of the lacrimal canals. The tubes are removed after approximately six months. Child care all this time is carried out according to the same scheme as after a standard operation.
Alternative sounding options
Can surgery be avoided? The only alternative sensing option is to massage the lacrimal canals in newborns. The purpose of this procedure is to break the gelatin film, which provokes blockage. In more detail about it should tell a pediatrician. Before carrying out the manipulations, you need to wash your hands thoroughly so as not to bring the infection into the eyes of the child.
The technique for massage the lacrimal canal in newborns is reduced to the following rules:
- First, you need to wipe the baby's eyes with a cotton swab dipped in a solution of "Furacilina". To do this, one tablet of the product must be dissolved in 100 ml of warm water. It is important for each eye to use a new swab, and it is better to wipe from the outer edge to the inside.
- Gently push down on the area above the lacrimal canal and slide your fingers to the base of the nose.
- Repeat for about 10 times.
- The secretions that appear during the procedure should be carefully removed with a clean cotton swab.
- At the final stage, it is recommended to instill anti-inflammatory drugs in the child’s eyes.
Doctors advise such a massage during feeding. The procedure is recommended to be repeated up to 6 times a day for two weeks. If after this period the symptoms of dacryocystitis do not disappear, it is necessary to do a sounding of the lacrimal canals.
It is worth noting that resorting to alternative methods of treating pathology is not worth it. The child’s visual apparatus is still not well developed, and the skin around the eyes is very sensitive. The use of recipes of alternative medicine can only aggravate the situation, adversely affect the well-being of the newborn.
Parent reviews
Unfortunately, many parents try to independently treat dacryocystitis, guided by the advice of relatives or friends. This approach is highly undesirable. The progression of the disease and the lack of competent therapy can only aggravate the situation. If at the initial stage it is possible to stop the manifestations of pathology through massage, then with advanced forms, one can not do without the help of sensing the lacrimal channels.
Adults have an opinion about this procedure. Most of them speak positively about her. Indeed, sounding is a fairly simple procedure that can cope with the blockage of lacrimal sacs. An experienced specialist takes just a few minutes to conduct it, and the result justifies the time spent. After a few days, the positive effect of the intervention becomes noticeable.
Negative opinions do not bypass the sounding of the lacrimal canals of the eyes. However, most of them are associated with the process of preparing a newborn for the procedure. A few hours before it is necessary not to feed the baby. If such a measure can be explained to a grown-up child, then things are much worse with a nursing baby.
The second negative point is swaddling. It's no secret that modern parents refuse these activities. Immediately after the hospital, they dress their children in familiar clothes and do not use diapers. Therefore, many babies, being "connected", begin to get scared and shout even more. However, pediatricians offer their own solution to the problem - to use a "sleeping bag". This product can now be purchased at all children's stores. Being in it, the child feels absolutely comfortable, and his hands do not interfere with the doctor's manipulation.
Finally
Sounding is an effective procedure. When carried out correctly, the risk of complications is reduced to zero. At the same time, the probability of a favorable outcome is maximum. However, before the procedure, doctors advise trying to restore the patency of the lacrimal canal by conservative methods, for example, using massage. If, despite all the suffering, the baby’s eyes continue to water, purulent discharge appears, you can’t do without surgery. In the hands of an experienced specialist, the procedure does not cause significant discomfort and is well tolerated even by very young children.