Post-traumatic canalicular fistula: description and review of literature – SALDO update study (SUP) – paper II

ABSTRACT

Purpose

To discuss the clinical spectrum and management strategies in patients with post-traumatic canalicular fistula (PTCF).

Methods

Retrospective, interventional case series of consecutive patients diagnosed with PTCF over a 6-year study period between June 2016 and June 2022. The demographics, mode of injury, location, and communication of the canalicular fistula were noted. The outcomes of several management modalities including dacryocystorhinostomy, lacrimal gland therapies, and conservative approaches were assessed.

Results

Eleven cases with PTCF over the study period were included. The mean age at presentation was 23.5 years (range: 6–71 years), with male: female ratio of 8:3. The median time interval between trauma to presentation at the Dacryology clinic was 3 years (range: 1 week to 12 years). Seven had iatrogenic trauma and four had the canalicular fistula following primary trauma. Management modalities pursued include conservative approach for minimal symptoms, and dacryocystorhinostomy, dacryocystectomy, and lacrimal gland botulinum toxin injection. The mean follow-up period was 30 months (range: 3-months−6 years).

Conclusion

PTCF is a complex lacrimal condition and the management of the PTCF needs a tailored approach guided by its nature and location and patient symptomatology.

KEYWORDS:

• Canalicular fistula
• canalicular trauma
• post-traumatic canalicular fistula
• lacrimal fistula
• lacrimal

Disclosure statement

MJA receives royalties from Springer for his treatise “Principles and Practice of Lacrimal Surgery,” and “Atlas of Lacrimal Drainage Disorders,” and “Video Atlas of Lacrimal Drainage Surgery.”

Additional information

Funding

Hyderabad Eye Research Foundation.