Opstrukcija suznog puta u dojenčadi
DOI:
https://doi.org/10.13112/pc.1066Ključne riječi:
OPSTRUKCIJA SUZNOG KANALA; SUZNI KANAL; DOJENČESažetak
Opstrukcija suznog puta u dojenčadi je relativno čest poremećaj u pedijatrijskoj populaciji (5-20 %) i pedijatri u primarnoj zdravstvenoj zaštiti se s ovom problematikom često susreću. Najčešće je uzrokovan perzistentnom membranom u donjem dijelu nazolakrimalnog kanala, ali su moguće i opstrukcije na drugim dijelovima suznog puta koje se mogu dijagnosticirati različitim dijagnostičko terapijskim metodama. Posebnost ovog poremećaja je što u kliničkoj slici ima česte konjunktivitise ili stanja slična konjunktivitisu što uzrokuje učestalu i nepotrebnu upotrebu antibiotika.
Normalan protok suza se najčešće uspostavi konzervativnim liječenjem u većine bolesnika do kraja prve godine života, ali je potrebno obučiti roditelje pravilnoj masaži suzne vrećice. Time pomažemo ranijem uspostavljanju protoka suza, smanjujemo rizik od infekcije i izbjegavamo kasniju opću anesteziju te moguće komplikacije operativnog zahvata.
Sondiranje se pokazalo kao uspješna invazivna metoda do treće godine života ukoliko konzervativno liječenje ne uspije.
Reference
1. MacEwen CJ, Young JD. Epiphora during the first year of life. Eye (Lond). 1991;5:596–600. doi: 10.1038/eye.1991.103.
2. Petersen RA, Robb RM. The natural course of congenital obstruction of the nasolacrimal duct. J Pediatr Ophthalmol Strabismus. 1978;15:246–50. doi: 10.3928/0191-3913-19780701-14.
3. Olitsky SE. Update on congenital nasolacrimal duct obstruction. Int Ophthalmol Clin. 2014;54:1–7. doi: 10.1097/IIO.0000000000000030.
4. Saraniya S, Ryan F, Brian GM. Spontaneous resolution and timing of intervention in congenital nasolacrimal duct obstruction. JAMA Ophthalmol. 2018;136(11):1281–6. doi: 10.1001/jamaophthalmol.2018.3841.
5. MacEwen CJ, Young JD. The fluorescein disappearance test (FDT): an evaluation of use in infants. J Pediatr Ophthalmol Strabismus. 1991;28:302–5.
6. Stolovitch CM. Hydrostatic pressure as an office procedure for congenital nasolacrimal duct obstruction. J AAPOS. 2006;10:269–72. doi: 10.1016/j.jaapos.2006.02.009.
7. Lee KA, Chandler D, Repka MX, et al. A randomized trial comparing the cost-effectiveness of two approaches for treating unilateral nasolacrimal duct obstruction. Arch Ophthalmol. 2012;130:1525–33. doi: 10.1001/archophthalmol.2012.2853.
8. Orhan M, Cal P, Onerci M, Irkec M. Conventional or endoscopic probing for congenital nasolacrimal duct obstruction. Eur J Ophthalmol. 2001;11:215–7. doi: 10.1177/112067210101100301.
9. Young JD, MacEwen CJ, Ogston SA. Congenital nasolacrimal duct obstruction in the second year of life: a multicenter trial of management. Eye (Lond). 1996;10:485–91. doi: 10.1038/eye.1996.107.
10. Repka MX, Chandler DL, Bremer DL, Collins ML, Lee DH. Repeat probing for treatment of persistent nasolacrimal duct obstruction. J AAPOS. 2009;13:306–7. doi: 10.1016/j.jaapos.2009.02.008.
11. Petris C, Liu D. Probing for congenital nasolacrimal duct obstruction. Cochrane Database Syst Rev. 2017;7:CD011109. doi: 10.1002/14651858.CD011109.pub2.
12. Lim CS, Martin F, Beckenham T, Cumming RG. Nasolacrimal duct obstruction in children: outcome of intubation. J AAPOS. 2004;8:466–72. doi: 10.1016/j.jaapos.2004.06.013.
13. Repka MX, Melia BM, Beck RW, Atkinson CS, Chandler DL, Holmes JM. Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than four years of age. J AAPOS. 2008;12:445–50. doi: 10.1016/j.jaapos.2008.03.005.
14. Repka MX, Chandler DL, Holmes JM, Hoover DL, Morse CL, Schloff S, Silbert DI, Tien DR; Pediatric Eye Investigator Group. Balloon catheter dilation and nasolacrimal duct intubation for treatment of nasolacrimal duct obstruction after failed probing. Arch Ophthalmol. 2009;127:633–9. doi: 10.1001/archophthalmol.2009.66.
15. Struck HG, Weidlich R. Indication and prognosis of dacryocystorhinostomy in childhood: a clinical study 1970–2000. Ophthalmologe. 2001;98:560–3. doi: 10.1007/s003470170119.
16. Čupak K, et al. Oftalmologija: Suzni uređaj. Zagreb: Nakladni zavod Globus; 2004. p. 347–60.
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Autorska prava (c) 2025 Siniša Skelin, Željana Matutinović Odak, Boško Jakšić
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