Selection of surgical intervention for congenital dacryocystocele

Zhang, Yi; Fan, Yu; Fan, Jinlu; Cui, Yanhui

doi:10.1177/1120672118785276

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…Recent studies suggest endoscopic evaluation in the diagnosis of CDC, concluding that nasal endoscopy surgery alone and/or antibiotic therapy had relatively safe and successful consequences for the treatment of CDC. [22][23][24] Unlike our results, in a series of 23 cases with CDCs, only 43 % (3/7) of the uncomplicated CDC patients recovered with conservative therapy. 25 Similar to our results, Levin and colleagues 26 documented that approximately 1/4 of the 19 CDC cases with secondary dacryocystitis improved with partial resolution of the infection following antibiotic treatment, but the patients needed lacrimal probing + marsupialization for absolute recovery.…”

Section: Discussioncontrasting

confidence: 97%

Outcomes of lacrimal probing surgery as the first option in the treatment of congenital dacryocystocele

et al. 2021

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Purpose: To determine the demographic and clinical characteristics of newborn patients who underwent lacrimal probing surgical intervention with or without the marsupialization of intranasal cysts as the primary management for dacryocystocele treatment. Methods: Data from the medical charts of 350 infants who underwent lacrimal probing surgery due to nasolacrimal duct obstruction were reviewed retrospectively. Ten newborn patients with a naive diagnosis of congenital dacryocystocele were included in the study. Congenital dacryocystocele diagnosis was based on a triad of swelling in the inner canthal region, a bluish appearance, and epiphora. Lacrimal probing surgery accompanied by nasal endoscopy was planned for all patients as the first treatment option. Results: The mean age of the patients was 24.90 ± 7.15 days, with a range of 6–85 days. A total of 10 patients were included, comprising seven females and three males. The mean postoperative follow-up period was 38.7 ± 24.41 months. Five patients had left, four patients had right, and one patient had bilateral dacryocystocele. Seven eyes of the six patients had uncomplicated dacryocystocele, while the remaining patients had dacryocystocele with complications of dacryocystitis and/or preseptal cellulitis. All patients had intranasal cysts. All patients underwent one session of lacrimal probing surgery under general anesthesia; all with successful outcomes. Four patients with additional dacryocystocele-associated complications underwent combined intranasal marsupialization of the cyst wall. Discussion: Lacrimal probing surgery ± intranasal marsupialization of the cyst wall as a first treatment option can be effective for both congenital dacryocystocele and/or congenital dacryocystocele plus associated complications and provide complete resolution of dacryocystocele-related symptoms.

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Section: Discussioncontrasting

confidence: 97%

Outcomes of lacrimal probing surgery as the first option in the treatment of congenital dacryocystocele

et al. 2021

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“…Pink cystic masses can be directly observed by nasal endoscopy. The lower turbinate is usually pushed horizontally; if secondary infection occurs, the condition can rapidly develop into acute dacryocystitis and periorbital cellulitis [17]. Previous reports have described confirmation of the diagnosis by ultrasound [18] or magnetic resonance imaging [19].…”

Section: (3/3) Of Bilateral Patients Exhibited Intermittent Open-moutmentioning

confidence: 99%

Comparison of marsupialization under nasal endoscopy versus lacrimal probing for treatment of congenital dacryocystoceles: a report of 40 cases

Cui

Sun

Tang

et al. 2020

Preprint

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Background: This study was performed to compare the efficacy of marsupialization under nasal endoscopy versus lacrimal probing for the treatment of congenital dacryocystocele. Methods: A prospective randomized controlled study. Forty neonates (43 eyes) diagnosed with congenital dacryocystoceles were divided into Group A (nasal endoscopic marsupialization) and Group B (lacrimal probing). The patients were followed up for 1 year after surgery. The efficacy, incidence of complications, and reoperation rate were compared between the two groups. Results: The male:female ratio was 25:15 patients (27:16 eyes). In Group A, the success rate was 100%, the incidence of complications was 5%, and the reoperation rate was 0%. In Group B, the success rate was 90%, the incidence of complications was 20%, and the reoperation rate was 30%. There was no significant difference in the success rate between the two groups, but the incidence of complications and the reoperation rate in the lacrimal probing group(Group B) were significantly higher than those in the nasal endoscopic marsupialization group(Group A). Conclusion: In the treatment of congenital dacryocystoceles, nasal endoscope marsupialization has the same success rate as lacrimal duct probing, but the former is more effective and safer in clinical practice.

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“…1,6,7 If the lacrimal sac worsens after two weeks of massage, it will be treated with probing and if fails, we consider surgical interventions such as endoscopic marsupialization, endoscopic intranasal dacryocystorhinostomy combined with marsupialization, or endoscopic intranasal dacryocystorhinostomy or nasolacrimal duct surgery. The study from Zhang et al 2 reported that all three previous procedures (endoscopic marsupialization, endoscopic intranasal dacryocystorhinostomy combined with marsupialization, or endoscopic intranasal dacryocystorhinostomy or nasolacrimal duct surgery) healed after one year of follow-up with no recurrence of symptoms and sign moreover none of the children needed re-operation. However, those procedures need an experienced surgeon for the accuracy of surgical positioning to ensure there is no damage on the mucous membrane of lacrimal duct system outside the operation area.…”

Section: Introductionmentioning

confidence: 98%

“…It is called mucocele when its contents of mucus and amniocele, that contents amniotic fluid. 1,2 The dilation is caused by the excretion of intraluminal goblet cells which are accumulated and trapped within the lacrimal sac with the appearance of the bluish lesion over the lacrimal sac. 3 One of the classifications is congenital dacryocystocele (CD), which may present directly after birth or within four weeks after.…”

Section: Introductionmentioning

confidence: 99%

“…The similar clinical features are found in capillary haemangionma, meningoencephalocele, mucocele, encephalocele, and nasal glioma. 2,3 The management of CD is still controversial. Schanall and Christian 5 found around 76% of CD resolved spontaneously within 2 weeks with conservative treatment such as warm compresses, massage, prophylactic topical and systemic antibiotic.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic dacryocystorhinostomy as an option management of syndrome-related congenital dacryocystocele: a case report

Irawati

Ernanda

Priscilia

et al. 2021

JMedSci

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Congenital dacryocystocele (CD) is a rare anomaly of the medial region of the orbit, caused by distal at the level of the valve of Hasner and proximal at the level of the valve of Rosenmuller obstruction of the lacrimal system. It may present as isolated abnormalities or maybe associated with syndromes. We described a neonate with a history of bilateral enlarged lacrimal sacs below medial canthal tendon with blue-grayish color and epiphora. Computed tomography (CT) scan resulted in congenital dacryocystocele. She was given topical antibiotics and Crigler massage as conservative treatment. In the first week, the right eye got a complete resolution. Otherwise, the left eye's lesion was worsening. The patient underwent endoscopic dacryocystorhinostomy (En-DCR) and silicone intubation on the left eye. Epiphora resolved with no recurrence at one month follow up. Conservative treatment and En-DCR have a success rate with no complication and widely used nowadays. In the case of CD associated with a syndrome, multidiscipline workups and treatment are essential.

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Selection of surgical intervention for congenital dacryocystocele

Abstract: Nasal endoscopic surgery is relatively safe, with high success rate for treatment of congenital dacryocystocele. Systematic training is required to promote the application of nasal endoscopy, so that more ophthalmologists can learn this technique.

Cited by 10 publications

References 25 publications

Outcomes of lacrimal probing surgery as the first option in the treatment of congenital dacryocystocele

Outcomes of lacrimal probing surgery as the first option in the treatment of congenital dacryocystocele

Comparison of marsupialization under nasal endoscopy versus lacrimal probing for treatment of congenital dacryocystoceles: a report of 40 cases

Endoscopic dacryocystorhinostomy as an option management of syndrome-related congenital dacryocystocele: a case report

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