Analysis of bicanalicular nasal intubation in the repair of canalicular lacerations

Purpose: To analyze the outcomes (success, failure) and complications of surgical repair of canalicular lacerations by bicanalicular nasal intubation in a series of patients treated over a 7-year period. Methods: The case records of 98 patients undergoing surgical repair of canalicular lacerations were retrospectively reviewed. Patient characteristics and results of the surgical repair were analyzed to identify factors that may influence the outcomes. Two groups (success and failure) were statistically compared with the Mann-Whitney U test for scale variables and with Fisher's exact test for categorical variables. Results: Of the 98 patients, 78 (79.6%) had patency after irrigation (anatomic success) and 83 (84.7%) were asymptomatic (functional success). Patients age, sex, injury location, anesthetic methods, and timing of surgical repair were not significantly associated with the postoperative patency of the lacerated canaliculus. Having a stent left for more than 90 days was significantly associated with restoration of the canalicular anatomy (P < 0.01). Patients with postoperative anatomic patency had a significantly lower rate of symptomatic epiphora than patients with anatomic obstruction (P < 0.001). Symptomatic epiphora was significantly more frequent in patients with combined upper and lower canalicular injuries (P < 0.01). Conclusion: Our results suggest that retaining bicanalicular silicone nasal intubation for more than 90 days can provide satisfactory results in restoring both canalicular anatomy and function. With an experienced operating team, repair of canalicular lacerations can be delayed for up to 11 days. However, patients with combined upper and lower canalicular lacerations are at an increased risk of developing postoperative symptomatic epiphora.