Nasolacrimal Duct Cyst Research Articles

Endoscopic marsupialization of congenital nasolacrimal duct cyst with dacryocoele.

A congenital nasolacrimal duct cyst is an uncommon condition in the newborn usually treated by ophthalmologists. Prolapse or expansion of the cyst into the nose may lead to respiratory distress and difficulty in feeding as newborns are obligate nose breathers, which needs the involvement of the Otolaryngologist in diagnosis and management. The authors report a series of 8 children presenting with a congenital nasolacrimal duct cyst and dacryocoele and highlight the importance of endoscopic nasal examination of newborns presenting with respiratory problems. Diagnostic studies included intranasal endoscopy and CT scanning of the nasolacrimal system and nose. All the patients were treated by endoscopic marsupialization of the cyst. Nasolacrimal duct abnormality should be considered in the differential diagnosis of neonatal respiratory distress and nasal obstruction. Nasal endoscopy is essential in the work-up of all children with nasal obstruction and respiratory distress. CT scanning is the investigative method of choice. Endoscopic marsupialization followed by lacrimal duct irrigation is effective in the treatment of congenital nasolacrimal duct cyst and results in complete resolution of symptoms.

Balloon catheter dilation for treatment of persistent nasolacrimal duct obstruction

PURPOSE: To report the outcome of balloon catheter dilation of the lacrimal duct for treatment of children with persistent nasolacrimal duct obstruction after previous surgery. DESIGN: Interventional case series. METHODS: Thirty-two consecutive children with a history of persistent nasolacrimal duct obstruction following previous surgery were treated with nasolacrimal duct probing with balloon catheter dilation of the distal nasolacrimal duct. Patients were excluded from this study if they had a history of facial trauma, systemic disorders that involved the lacrimal system, or nasolacrimal duct cysts. Outcomes were considered excellent if the patient had complete symptomatic resolution of epiphora and dacryocystitis and normal tear drainage on examination, good if the patient had only minimal residual symptoms or a minimally delayed dye disappearance test, fair if the patient had moderate residual symptoms or delayed tear drainage, and poor if there was no improvement. RESULTS: Thirty-two children (20 with bilateral nasolacrimal duct obstruction and 12 with unilateral nasolacrimal duct obstruction) underwent balloon catheter dilation. Overall results were excellent in 9 (28%) patients, good in 15 (47%) patients, fair in 7 (22%) patients, and poor in 1 (3%) patient. Seven patients had undergone more than one previous procedure. Of these patients, 3 had excellent outcomes, 2 had good outcomes, 1 had a fair outcome, and 1 had a poor outcome following balloon catheter dilation. CONCLUSIONS: Balloon catheter dilation is a safe and generally effective treatment for children with persistent symptoms of nasolacrimal duct obstruction following previous surgery.

Endoscopic marsupialization of bilateral lacrimal sac mucoceles with nasolacrimal duct cysts

A lacrimal sac mucocele is an uncommon disease usually treated by ophthalmologists. In rare cases, it is sometimes associated with a nasolacrimal duct cyst presenting as an intranasal cystic mass, which needs the involvement of an otolaryngologist in diagnosis and management. Two cases of lacrimal sac mucoceles with nasolacrimal duct cysts are presented with a brief literature review. Both cases presented with intranasal cystic masses that caused nasal obstruction and were cured with endoscopic marsupialization of the cysts.

A multidisciplinary approach to atypical lacrimal obstruction in childhood.

This study explores the diagnosis and management of unusual anomalies involving the canaliculi, nasolacrimal duct, nasal cavity, and sinuses in childhood. A case series of eight children with lacrimal outflow anomalies ranging from distal nasolacrimal duct cyst formation to persistent dacryocystitis following failed probing or silicone intubation were reviewed retrospectively. Diagnostic studies including intranasal endoscopy and preoperative or intraoperative dacryocystography (DCG) were of value. Treatment modalities included endoscopically guided resection of lacrimal cyst mucosa, endoscopic dacryocystorhinostomy (DCR), and monocanalicular or bicanalicular intubation of the lacrimal outflow system. In our series, endoscopic surgery was well tolerated by all patients with improvement in symptoms. This initial experience suggests that endoscopic techniques may be useful in the management of atypical lacrimal outflow obstruction in childhood.

Neonatal Lacrimal System Anomalies

Abnormalities of the neonatal lacrimal system result from incomplete or abnormal embryologic formation of the structures that drain tears from the eye into the nose. The most common of these, nasolacrimal duct obstruction, often resolves spontaneously. Less common abnormalities, including neonatal dacryocystitis associated with nasolacrimal duct cysts, atresia of the lacrimal canaliculi and puncta, and lacrimal fistulae, usually require surgical intervention. The developmental origin, clinical signs and symptoms, and management of these entities are discussed.

Congenital nasolacrimal duct cysts with nasal obstruction

Congenital nasolacrimal duct cysts with nasal obstruction

Congenital nasolacrimal duct cysts with nasal obstruction

Congenital nasolacrimal duct cysts with nasal obstruction

Endoscopic Diagnosis and Treatment of Nasolacrimal Duct Cysts Causing Upper Airway Obstruction in the Neonate

Endoscopic Diagnosis and Treatment of Nasolacrimal Duct Cysts Causing Upper Airway Obstruction in the Neonate

How I do it: Head and neck and plastic surgery: Nasal obstruction in the neonate secondary to nasolacrimal duct cysts

How I do it: Head and neck and plastic surgery: Nasal obstruction in the neonate secondary to nasolacrimal duct cysts

Nasolacrimal duct cysts in congenital dacryocystocele

Nasolacrimal duct cysts in congenital dacryocystocele

Respiratory distress associated with bilateral nasolacrimal duct cysts

Nasolacrimal duct system cysts with intranasal extension is a rarely reported cause of respiratory distress in the newborn. Nine often previously reported patients have demonstrated a paranasal mass on examination. Most of these patients have been female and most have required surgical intervention to relieve the obstruction. We present a case of a male newborn with bilateral NLDS cysts with intranasal extension causing respiratory distress, and no evidence of paranasal mass on examination. Nasal endoscopy is essential in the work-up of all patients with nasal obstruction and respiratory distress. The MRI scan was used in the diagnostic work-up to further evaluate the condition. The NLDS cyst with nasal extension resolved spontaneously.

Congenital Nasolacrimal Duct Cysts in Dacryocystocele

Cystic intranasal masses were found in seven newborn infants with congenital dacryocystocele. The cysts were a direct extension of the nasolacrimal duct, located beneath the inferior turbinate. Nasal obstruction was present in three infants and was severe enough to cause respiratory distress in two neonates with bilateral cysts. Using fiberoptic nasal endoscopy, treatment consisting of probing, irrigation, and marsupial ization of the cysts was successful in all infants. The authors believe this rarely reported anomaly is a more common finding in dacryocystocele than previously recognized and advocate careful nasal examination in all infants with congenital dacryocystocele. Early diagnosis and treatment of this condition is critical in the infant with nasal obstruction.

Nasal obstruction in the neonate secondary to nasolacrimal duct cysts

The neonate is an obligate nasal breather and any form of nasal obstruction causes respiratory distress during feeding and sleeping. We report two patients with unusual causes of respiratory distress secondary to nasolacrimal duct cysts. The failure of the lacrimal duct to perforate at the distal end results in dacryocystitis and cyst formation. Removal of the nasal wall of the cyst resolves the obstruction and the dacryocystitis. The nasolacrimal duct cyst is an unusual, but readily treated, cause of neonatal respiratory distress.