Computed tomography in treatment decision making in children with lacrimal drainage disorders

The impossibility of lacrimal apparatus direct examination impedes the diagnostics of its disorders, particularly in younger children. Modern diagnostic technology, multi-spiral computed tomography (CT), can help to resolve this problem. However, this method is rarely used in pediatrics. Contrast-enhanced CT of lacrimal ducts was performed in 37 children (41 eyes) with lacrimal drainage disorders (local obstruction on various levels, n = 20; posttraumatic changes, n = 8; tumors, n = 4). Ultravist was used as a contrast since its viscosity and pH are similar to tear. Additionally, this agent has low toxicity and good tolerability (these characteristics are of great value for this age group). The indications were nasolacrimal duct obstruction; associated lacrimal ducts and surrounding tissues trauma; concomitant ear, nose, and throat problems; lacrimal sac tumors. Multi-spiral CT identified the cause and the level of lacrimal ducts obstruction as well as the relationship between the ducts and surrounding tissues. Detailed lacrimal ducts examination by multi-spiral CT provided pathogenically relevant treatment thus increasing its efficacy. The treatment restored tear drainage in 100 % of children. Ear, nose, and throat problems that accompany lacrimal drainage disorders affects the outcome of forthcoming surgery. Their pre- or intraoperative treatment increases the efficacy of the procedure. Water-soluble contrast, Ultravist, is safe and decreases exam

time. Multi-spiral CT provides 3 D image reconstruction which is of great importance for data interpretation.

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