Superior versus Inferior Monocanlicular Stent
Retention in the Pediatric Population
Brian Sajorda BA, Jana Bregman MD, Jonathan Taylormoore MD, Bethany Karwoski MD, Kelly Hutcheson MD, William Madigan MD, Richard Birdsong MD, Monica Manrique MD, Heather de Beaufort MD
Monocanalicular stents are an attractive alternative to bicanalicular intubation for pediatric canalicular trauma and refractory NLDO. It has not been established whether superior versus inferior placement impacts post-operative outcomes. The purpose of this study is to address whether superior versus inferior monocanalicular stent placement impacts post-operative outcomes in the pediatric population. A single site, retrospective review of patients aged 6 months to 16 years with monocanalicular stent placement between January 2009 and March 2020 was done. Statistical analysis was conducted using Fisher’s exact test. 44 eyes of 38 patients were analyzed. A majority were placed inferiorly (n= 27, 61.4%). Primary analysis revealed a trend towards more cases of early extrusion in the superior group (n=7, 41.2%) versus the inferior group (n=6, 22.2%). There were also more cases of early extrusion in males versus females (37.5% v. 20.0%) and patients under 5 years old (32.0% v 26.3%). Indication (trauma v. refractory NLDO) did not impact extrusion. Postoperative complications were similar between the two groups. Preliminary results revealed that superior placement, male sex and younger age may be risk factors for premature stent extrusion. Review is ongoing to further power this study and elucidate these findings. Data collection is ongoing to further power this study. Significant findings may help optimize surgical decision making for pediatric monocanalicular stent placement.
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