Congenital nasolacrimal duct mucocele: a cause of respiratory distress

Lacrimal Sac Mucocele in a Newborn: A Rare Mimic of Congenital Intranasal Tumor

“…The signal intensity of cyst content was helpful in characterizing of the lesion, allowing us to differentiate it from similar soft-tissue pathologies, in particular, dermoid cyst. The low signal on T1-and high signal on T2-weighted images were consistent with the mucoid or proteinaceous material, a usual finding in a mucocele [15].…”

“…The clinical picture, which usually consists of a medially-placed blue-grey-colored canthal mass, epiphora, overflow of tears, and mucoid ocular discharge may become complicated with dacryocystitis, preseptal/orbital cellulitis, or even sepsis [2,4,15,21,22]. In the presented case, there was no sign of lacrimal sac mucocele except for respiratory distress.…”

“…Ultrasound is a simple and non-invasive method for reliably distinguishing mucocele from solid masses; but it may not provide a definite differentiation from cystic lesions, such as dermoid cyst, epidermoid cyst, encephalocele, and hemangioma. Computed tomography has the advantage of detecting bone changes involving the bony portion of the nasolacrimal canal; but MRI seems more advantageous in newborns because of its superior delineation of unusual morphology and maturation of the frontonasal region and absence of radiation exposure [15,25]. Another advantage of MRI is the in-utero applicability.…”

“…Nasal obstruction is an important cause of respiratory distress, particularly in the neonatal period [4]. Although the most common cause of nasal obstruction in neonates is choanal atresia/ stenosis, congenital cysts, hamartomas, hemangiomas, encephalocele, and congenital neoplasms should also be considered in differential diagnosis [4,15]. Lacrimal sac mucocele, either unilateral or bilateral, occur when the nasolacrimal pathway is obstructed and it is a rare anomaly in the newborn [2,5].…”

Endoscopic Management of Pediatric Nasolacrimal Anomalies

“…Respiratory distress would be commonly associated with congenital dacryocystocele with nasal extension because infants are obligate nasal breathers, [7][8][9] and bilateral ones can cause lifethreatening airway obstruction. On examination after a proper decongestion of nose, endoscopy will reveal a cystic mass arising from the undersurface of inferior turbinate, which will be soft and compressible when palpated with a nasal probe or suction, or sometimes just redundant mucosa without an obvious mass is visualized.…”