The AAO Journal, 2014/06, 24(2):25, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

dacryostenosis [1]
newborns [11]
male [861]
ocular discharge [1]
osteopathic manipulative treatment [3946]
OMT [3925]
case report [736]

Abstract:

Dacryostenosis is found in up to 20% of newborns and up to 6% are symptomatic. While 90% of cases resolve spontaneously within 6 months, the rate of spontaneous resolution decreases after 6 months, and invasive treatment may be necessary. The standard of care for symptomatic patients younger than 6 months is nasolacrimal massage and topical antibiotics as needed. After 6 months of age, nasolacrimal probing under anesthesia may be required. The authors present a case of persistent dacryostenosis in a 9-month-old male patient with recurrent epiphora and ocular discharge since birth. He was scheduled for surgical nasolacrimal probing because he showed little improvement with standard treatments. Osteopathic examination revealed several cranial and cervical somatic dysfunctions, and they were addressed with cranial and cervical techniques. The patient’s epiphora improved immediately, and it continued to improve during the following weeks and months. At 6 months post-treatment, the patient no longer needed surgical probing. This case suggests that osteopathic manipulative medicine (OMM) can help relieve nasolacrimal duct stenosis by addressing the somatic dysfunctions of the cranial bones, improving cranial bone articulation, and augmenting the drainage of the lymphatics of the head and neck. In turn, this may decrease epiphora and dacryocystitis, ultimately decreasing patient discomfort and the need for invasive and expensive procedures.