Endoscopic Surgical Management of Dacryocele

Abstract

Objectives: 1) Report our experience and surgical treatment of the unilateral giant dacryocele using the endoscopic technique. 2) Improve the lacrimal sac treatment with endonasal surgery, thus avoiding external dacryocystorhinostomy and its sequelae. Methods: We present the case of an adult patient with chronic dacryocystitis of 1 year of evolution, treated by endoscopic endonasal surgery (endoscopic dacryocystorhinostomy) in July 2012 at the Arzobispo Loayza National Hospital, Lima, Peru. The computed tomography described a giant mucocele of the right lacrimal sac. The technique was done entirely endoscopically, opening the lacrimal bone and the lacrimal sac with mucosal content and using a silicone probe. Nasal packing was placed for 3 days, and endoscopic control was carried out. Results: This patient was followed endoscopically each week, testing the permeability of the fistula, moving the probe, and checking the opening hole during the 6 months after surgery. There were no recurrences and no complications. Conclusions: Endoscopic dacryocystorhinostomy has become a very safe method to resolve lacrimal sac pathologies. It is a reliable and secure and has less sequelae than external dacryocystorhinostomies.