[Therapy for congenital dacryostenosis].

The congenital dacryostenosis occurs frequently in about 5 % of all newborns. It may occur both as a unilateral and as a bilateral form with a family disposition for dacryostenosis. In a large number of cases we see a stenosis of the ductus nasolacrimalis due to a persistant membrane of Hasner or due to a mucosa plaque. The conservative treatment starts with lacrimal sac massage, detumescent eyes and nose drops. With further permanent complaints, probing of the lacrimal passages in a so-called "bundle wrap anaesthesia" may be performed depending on the age and physical appearance of the child. Further probing and silastic tube intubation under general anaesthesia should be performed in the case of persistence. Apart from the congenital stenosis we rarely find other alterations of the lacrimal system like aplasia of the canaliculi, saccus or ductus nasolacrimalis as well as tear duct diverticles or even fistula of the canaliculi or saccus which may lead to permanent epiphora. Facial disorders or dysmorphias with involvement of the lacrimal passages have to be accessed separately, with participation of various disciplines such as radiology, ear nose throat surgery, cranial-facial surgery and neurosurgery and therefore the patients need individual management and treatment.