Abstract
Congenital bilateral dacryocystocele with concomitant congenital nasal pyriform aperture stenosis is a very rare case we seen in the paediatric age group. We report a case referred by the paediatric department to rule out choanal stenosis. The referring department had difficulty to insert a feeding tube to the patient. Nose and throat examination showed reduce misting on cold spatula test and unable to introduce nasoendoscope into both nostrils, which indicates obstruction. Radiological investigation revealed as congenital dacryocystocele with nasal pyriform aperture stenosis. The patient was managed surgically with good recovery.
Highlights
Case ReportCongenital dacryocystocele with congenital nasal pyriform aperture stenosis (CNPAS) is an uncommon congenital case
Neither dacryocystocele nor nasal pyriform aperture stenosis will have both abnormalities at the same time
We report a case of a full-term infant of a mother with Gestational Diabetes Mellitus (GDM) who has been taking subcutaneous insulin during the pregnancy
Summary
Congenital dacryocystocele with congenital nasal pyriform aperture stenosis (CNPAS) is an uncommon congenital case. Neither dacryocystocele nor nasal pyriform aperture stenosis will have both abnormalities at the same time. It should be confirmed by computed tomography (CT) scan of the paranasal sinus Both congenital, if bilaterally obstructed will cause of respiratory distress or feeding difficulties especially in newborn. CT scan reported as bilateral soft tissue lesion medial to the globe likely lacrimal lesion, no fat content to suggest dermoid cyst (Figure 1), narrowing of bilateral nasal aperture suggestive of stenosis (Figure 2), and presence of solitary maxillary central mega incisor. Operative findings showed narrowing of the bilateral nasal pyriform aperture with a deviated nasal septum to the left and bulging of the nasolacrimal duct (dacryocystocele), with normal choana opening bilaterally. Malaysian Journal of Paediatrics and Child Health (MJPCH) | (Early Online - June 2021) | Page 28 of 30
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