Congenital dacryocystocele associated with intranasal cysts: diagnosis and management

Laryngoscope. 2003 Jan;113(1):37-40. doi: 10.1097/00005537-200301000-00007.

Abstract

Objective: To improve the diagnostic and therapeutic database for congenital dacryocystoceles.

Study design/methods: Retrospective case study of 10 patients with dacryocystoceles treated in an academic integrated tertiary care practice. Management and outcomes are compared to previous reports in the literature.

Results: Between the years 1990 and 2001, 10 patients were diagnosed with dacryocystoceles. Seven were females, and 3 were males. Age ranged from 1 to 75 days. Nine of 10 had a unilateral dacryocystocele, and 1 had bilateral dacryocystoceles. Epiphora was reported in 8 patients. Preoperatively, dacryocystitis, facial cellulitis, or both were present/developed in 2 patients. Symptoms of airway obstruction were present in 3 neonates. Surgery was performed in 9 of 10 patients and was a combined ophthalmology/otolaryngology surgery in 7 cases. Two patients were treated with probing only. Intranasal cysts were identified in all 7 patients who underwent a combined approach. Three of 7 patients had bilateral intranasal cysts. Follow-up ranged from 9 months to 10 years (mean, 5 years). Complete resolution was observed in 9 patients. One patient had postoperative nasolacrimal duct obstruction 2 months postoperatively, presenting with mucopurulent drainage and cellulitis. The existing literature often suggests conservative management as a treatment option.

Conclusion: True dacryocystoceles are a relative rarity. The literature describes a variable natural course of these lesions with resultant controversy in their management. The current results demonstrate successful treatment in 6 of 7 patients with an early combined surgical approach and 2 of 2 patients treated by probing alone. The high failure rate with conservative management, reported in the literature, supports early surgical intervention.

MeSH terms

  • Cysts / complications
  • Cysts / congenital*
  • Cysts / diagnosis
  • Cysts / surgery*
  • Dacryocystorhinostomy* / methods
  • Endoscopy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Lacrimal Duct Obstruction / complications
  • Lacrimal Duct Obstruction / congenital*
  • Lacrimal Duct Obstruction / diagnosis
  • Male
  • Nasolacrimal Duct / abnormalities*
  • Nasolacrimal Duct / surgery
  • Nose Diseases / complications
  • Nose Diseases / congenital*
  • Nose Diseases / diagnosis
  • Nose Diseases / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Treatment Outcome