Dacryocystitis in newborns is often diagnosed. The disease is accompanied by an inflammatory process in the lacrimal sac, which develops against the background of complete obstruction or partial narrowing of the lacrimal canal. The disease gives the baby a lot of inconvenience.
Of course, many parents are interested in more information about this disease. Why does congenital dacryocystitis develop in newborns? What are the symptoms of the disease? Can pathology lead to complications? What treatment methods does modern medicine offer? The answers to these questions are sought by many readers.
Brief information about the disease
Dacryocystitis is a pathology that is accompanied by inflammation of the lacrimal sac. Often, such a disease is associated with impaired patency of the lacrimal canal, but there are other reasons. As you know, the mucous membranes of the lacrimal system directly in one way or another come into contact with the tissues of the nasal passages, which means that various pathogenic bacteria, viruses and other microorganisms easily enter the lacrimal sac - this is how purulent inflammation develops.
According to statistics, from this disease most often affects newborn children, as well as elderly people aged 60-70 years (this is due to changes in the body against the background of aging). The risk group includes patients with a rounded skull. In addition, girls are faced with a similar problem 6-8 times more often than newborn boys.
The main causes of the development of the disease
The main role in the development of this disease is played by impaired patency (or complete obstruction) of the nasolacrimal duct. Through the Gasner valve, he communicates the lacrimal sac cavity with the nasal cavity. Before birth, the lacrimal canal is closed with a film, which is formed from embryonic tissue. In the first months after birth, the cork dissolves, but sometimes for one reason or another this does not happen.
Nevertheless, cases are known in which dacryocystitis also developed against the background of the normal passage of the nasolacrimal duct.
Various microorganisms can penetrate from the nasal cavity into the lacrimal sac. Dacryocystitis often develops against the background of the activity of staphylococci, streptococci, Escherichia coli, candida fungi, Pseudomonas aeruginosa, pathogens of syphilis, tuberculosis, chlamydia.
Risk pathologies include ENT pathologies and various structural features of the middle zone of the skull, in particular, curvature of the nasal septum, hypertrophy of the nasal concha (its lower part), various traumatic injuries, and polyps in the nose. The likelihood of developing dacryocystitis increases against the background of vasomotor, allergic and hypertrophic rhinitis, the formation of tumor growth in the nose, various forms of sinusitis, etc.
Classification: varieties of pathology
In modern medical practice, dacryocystitis in newborns is often diagnosed. Reviews of doctors, as well as the results of scientific research, confirm that the disease can take various forms.
Depending on the course, inflammation can be acute or chronic. Dacryocystitis in a newborn can take a simple, catarrhal, purulent or phlegm form. If you pay attention to the etiology, then isolate viral, parasitic, bacterial, chlamydial and post-traumatic inflammation.
What symptoms should I look for?
Dacryocystitis in a newborn, as a rule, begins to appear several days after birth. On the other hand, if the lacrimal canal is not too narrow, then a later manifestation of symptoms is possible - after a few weeks.
The first sign is lacrimation - often it intensifies during a walk in the fresh air, against a background of changes in ambient temperature, etc. In the eyes of the baby there is always too much tear fluid.
As the disease progresses, the symptoms intensify. Mucous membranes, and sometimes mucopurulent discharge from the eye, appear, which indicates a more pronounced inflammation. Often, the child's ages stick together - during the night the discharge manages to dry out by gluing eyelashes. It is these symptoms that accompany dacryocystitis in newborns. Komarovsky, a well-known pediatrician, draws attention to the fact that this disease is often confused with ordinary conjunctivitis.
Nevertheless, as the disease develops, the disorders become more pronounced. To begin with, it is worth noting that conventional antiseptic and even antibacterial drops, which are effective for inflammation of the conjunctiva, with dacryocystitis give only a temporary result.
Tissues of the lower eyelid swell and blush. If you click on the area of the lacrimal sac, then you can observe the release of pus from the lacrimal canal. These are characteristic symptoms of dacryocystitis in a newborn. Palpation in this area is often accompanied by sharp pain, the baby begins to cry. Other symptoms include burning, itching in the eyes, conjunctival redness.
What is the disease dangerous? Is a complication possible?
If dacryocystitis has been diagnosed, the newborn needs adequate medical attention. In no case can the disease be ignored - it is important to strictly follow the doctor’s instructions.
In the absence of therapy, the inflammation of the lacrimal sac passes into a chronic form, which is much more difficult to cure. That is why the correct treatment of dacryocystitis in newborns is so important. Komarovsky says that, unfortunately, often the therapy begins too late, since the initial stages of the development of the disease resemble the clinical picture of conjunctivitis.
Sometimes, against the background of the inflammatory process, an abscess forms in the lacrimal sac - accumulation of pus in the membranes. If the abscess ruptures, then fistulas may appear - channels that connect the cavity of the bag to other tissues. There is a possibility of developing phlegmon of the orbit. The constant release of pus negatively affects the condition of the outer membranes of the eye - various damage to the conjunctiva, ulceration of the cornea, a sharp and persistent decrease in vision are possible.
In the most severe cases, the infection and the inflammatory process extend to other nearby organs. Sepsis and brain abscess are extremely rare complications of dacryocystitis. Nevertheless, the likelihood of such an outcome exists.
According to statistics, in about 14-16% of patients who have undergone such inflammation, small stones form in the lacrimal canal cavity, which require removal.
Diagnostic measures
As already mentioned, the initial symptoms of dacryocystitis are similar to signs of conjunctivitis. That is why in this case, the correct diagnosis is necessary.
As a rule, a general examination is enough for the doctor to suspect the presence of dacryocystitis. In the future, a blood test is performed - against the background of the inflammatory process, an increase in the level of leukocytes is observed.
In addition, sowing is carried out using samples taken from the conjunctiva and nasal mucous membranes. For the same analysis, a detachment from the lacrimal sac is taken. Such a study helps determine the nature of the pathogen.
In addition, other tests are used, for example, sounding and sonography (during the procedure, you can see the expansion of the lacrimal sac and fluid congestion). In the event that there is a suspicion of the presence of a tumor or dacryocystitis developed after an injury, the patient is referred for computed tomography. Sometimes, in order to establish the cause of the development of the inflammatory process, nasal endoscopy is performed.
Dacryocystitis in a newborn: treatment
In the initial stages, small patients are prescribed special medications. Such drops are widely used for dacryocystitis of newborns, such as Miramistin, Chloramphenicol, Sulfacil. The course of therapy lasts from 7 to 10 days.
No less effective is the drug "Tobrex" with dacryocystitis in newborns. This tool has pronounced antibacterial properties. In addition, it can be used for children of almost any age.
Therapy is often supplemented with special antibacterial ointments, for example tetracycline or erythromycin - they are laid over the eyelid at night. The treatment is supplemented by a daily jerking massage of the tear bag. Dr. Komarovsky recommends this particular treatment. In the initial stages, it really gives the desired effect.
If the patient has a phlegmon, then it is important to open it. After the procedure, drainage is carried out using a 10% solution of sodium chloride. The wound is washed with antiseptic solutions for another week.
Antibiotics for the disease
Since in most cases the inflammatory process is associated with the activity of bacterial microorganisms. As a rule, special antibacterial drops, coupled with other therapeutic procedures, are enough to cope with the disease. In the most severe cases, antibiotics are administered intramuscularly or intravenously to achieve maximum effect. Effective are:
- penicillins (the course of therapy lasts from 5 to 14 days);
- aminoglycosides (medicines are used for 5-10 days);
- cephalosporins, in particular, Ceftriaxone, Cefotaxime (treatment lasts from 5 to 14 days);
- sulfonamides, for example, "Cotrimoxazole", "Sulfadimidine."
Dacryocystitis in newborns: massage treatment
Of course, drops help to cope with the main symptoms. But equally important is a newborn eye massage. With dacryocystitis, this procedure should be performed regularly. This helps to remove purulent masses from the lacrimal sac and accelerate the healing process.
How to massage with dacryocystitis in newborns? It is better if the first few procedures are performed by a doctor or a nurse - so parents will have the opportunity to learn how to massage themselves.
Of course, before the procedure, you need to thoroughly wash your hands, prepare sterile cotton swabs and a solution of furacilin (it needs to be slightly warmed up to room temperature). At first, it is recommended to lightly press on the inner corner of the eye of the cushion index finger (remember that the skin, cartilage and other tissues of the baby are very sensitive, so do not press too hard). Next, you need to gently press on the lacrimal sac - through the lacrimal duct, a mucopurulent mass begins to stand out, which must be removed with a cotton pad soaked in a solution of furacilin. Pressing and sliding movements must be continued, moving along the bridge of the nose. After the massage ends, the eyes should be instilled with “Levomycetin” or other drops prescribed by the doctor.
Such manipulations are repeated 5 times a day. The duration of therapy is two weeks.
Probing for dacryocystitis
Sometimes the only method of treatment is probing the lacrimal canal. This procedure is prescribed if the disease develops over a long time, and massage and medications do not give the desired result.
The procedure is relatively simple. Under local anesthesia, the doctor inserts a special small probe into the lacrimal canal. Such manipulation eliminates the plug that clogs the channel. Also during the procedure, the lacrimal sac is cleaned of pus and washed with an antiseptic solution.
Next, the doctor prescribes eye drops for the small patient. After 1-2 weeks, the procedure is repeated again. In most cases, such treatment ends with a complete cure for the child.
In the most severe cases, a dacryocystorhinostomy is performed - a surgical procedure during which the doctor creates a new message between the nasal cavity and the lacrimal sac. Thus, the tear fluid can move around the clogged natural channel.
Alternative methods of treatment
Drug therapy can be supplemented with traditional medicine. Of course, it is not worthwhile to use them without prior consultation and permission from a doctor.
- Some folk healers recommend using Kalanchoe juice (if it comes to treating a child, then the juice is diluted with clean, boiled water) for instillation of the nose. It is believed that the juice of the plant has anti-inflammatory and bactericidal properties.
- For compresses, tinctures and decoctions of chamomile flowers, dill herbs, mint leaves are used.
- For eye washing, you can use concentrated tea leaves. By the way, you can simply moisten tea bags in hot water, cool them slightly and put on eyes.
Predictions for small patients
In fact, the forecasts are quite favorable. Timely diagnosis and proper treatment of dacryocystitis in a newborn in most cases ends with a full recovery. Complications are possible, but they are recorded only in isolated cases.
Prevention: how to prevent the development of the disease?
Unfortunately, there are no special medicines that could prevent the development of dacryocystitis. Prevention in this case comes down to regular washing of the eyes of the newborn. If the first symptoms appear, consult a doctor. At the initial stages, you can get rid of the ailment with the help of drugs, without resorting to sensing.