Management of congenital lacrimal fistula combined with eyelid cosmetic surgery / 中华医学美学美容杂志

Objective:To investigate the feasibility and availability of one-stage treatment for congenital lacrimal fistula combined with blepharoplasty and epicanthoplasty.Methods:From November 2014 to March 2021, 6 female patients with congenital lacrimal fistula and epicanthus were treated in the 2nd Department of Maxillofacial Plastic Surgery Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, aged 12-32 years (mean 24 years), including 5 unilateral lacrimal fistula and 1 bilateral.Results:During 3 to 40 months (mean 18 months) of follow-up, the ocular appearances were improved notably and the fistulas were removed completely. There was no secondary infection or cyst occurred, and no ectropion, traction or other deformities. The position of canthus was normal and the shape of canthus was good. The scars in the operation area were inconspicuous.Conclusions:Fistulectomy combined with blepharoplasty and epicanthoplasty can excise congenital lacrimal fistula effectively while improving the ocular appearance by this procedure.

Treatment of the Lacrimal Fistula with Punctal Plug

PURPOSE: To evaluate the results and complications of the punctal plug insertion through lacrimal fistula. METHODS: Four patients diagnosed with congenital lacrimal fistula had a punctual plug inserted through the lacrimal fistula without anesthesia from January to May 2005. RESULTS: Mean follow-up period was 6.8 months. In two pediatric patients whose mean age was 5.0 years, the fistula was not associated with nasolacrimal duct. In two adult patients, it was associated nasolacrimal duct obstruction, whose mean age was 49.0 years. In all cases epiphora improved. There was a puncal plug prolapse in one case and no other complications. CONCLUSIONS: Punctal plug insertion is considered a simple and useful technique for lacrimal fistula without congenital nasolacrimal obstruction in children especially whose parents refuse general anesthesia. Punctal plug insertion can be useful to reduce scarring in adult patients that receive endoscopic dacryocystorhinostomy with nasolacrimal obstruction.

The Clinical Evaluation of Congenital Lacrimal Fistula

PURPOSE: To evaluate the surgical results and clinical characteristics of congenital lacrimal fistula. METHODS: Fourteen patients were diagnosed with congenital lacrimal fistula and received simple fistulectomy. Three patients received anterior lamella reposition operation simultaneously due to epiblepharon. We retrospectively reviewed the medical records and conducted telephone interviews. RESULTS: In 15 eyes of the 14 patients, epiphora through lacrimal fistula disappeared. Two eyes of 2 patients showed a little epiphora only outdoors but there was no need of further treatment. All patients accepted the surgical results cosmetically. Histologically, stratified squamous epithelial change with keratinization was remarkable by aging. In adults, hair follicles with increased keratinization were contained and the result with skin was similar. CONCLUSIONS: Simple fistulectomy was a useful technique for congenital lacrimal fistula.

Surgery for the Congenital Lacrimal Fistula

PURPOSE: Congenital lacrimal fistula, a rare developmental disorder, was reviewed to evaluate clinical features and surgical techniques with its results. METHODS: The clinical features of 9 patients who received operation are retrospectively reviewed, including presenting symptoms, surgical techniques and their results. RESULTS: Excision of the fistula alone was performed for cosmetic blemish and excision of fistula with bicanalicular silicone tube intubation was done for symptomatic tearing. None of the 9 patients had symptomatic or cosmetic problem postoperatively. CONCLUSIONS: Fistulectomy with or without bicanalicular silicone tube intubation is a successful procedure for congenital lacrimal fistula.