Prevalence and clinical characteristics of congenital dacryocystocele

Abstract

Purpose To report the prevalence, clinical findings, and outcomes in children diagnosed with congenital dacryocystocele in a well-defined population over a 20-year period. Methods The medical records of all Olmsted County, Minnesota, patients diagnosed with congenital dacryocystocele from January 1, 1988, through December 31, 2007, were retrospectively reviewed. Results A total of 9 children were diagnosed with dacryocystocele during the 20-year period, yielding an incidence of 1 in 3884 live births. The median age at diagnosis was 12 days (range, birth to 40 days); 7 (78%) were female. Eight patients (89%) had unilateral disease. Clinical findings included a cystic mass in all 9, dacryocystitis in 3 (33%), intranasal cysts in 3 (33%), and 1 (11%) each with facial cellulitis and dacryocystocele-induced astigmatism. Conservative treatment resolved the obstruction in 3 (33%), while the remaining 6 (67%) each underwent one surgery. Complete resolution was observed in all 9 patients. Conclusions Congenital dacryocystocele is an uncommon unilateral condition of predominantly neonatal females. Clinical findings support a relatively high incidence of complications such as dacryocystitis and intranasal cysts as well as a less common finding of astigmatism that resolved without evidence of amblyopia. One-third of the cases were successfully managed with conservative treatment alone; most patients required surgical intervention.

Associated signs, demographic characteristics, and management of dacryocystocele in 64 infants

“…8,12 This greater incidence has been attributed to the presence of a narrower nasolacrimal duct in females than males and a more acute angle between the canal and the nasal floor, resulting in a greater likelihood of obstruction. 13 Despite this possible anatomical difference, multivariate analysis showed no correlation between the sex of the child and the choice of, or need for, a particular intervention.…”

“Double eyes” sign of congenital bilateral dacryocystoceles

“…After birth, gray-blue-colored mucoid material in cystic swellings below the medial canthus is typically observed [2]. Congenital dacryocystoceles generally present after 30 weeks' gestation, with an incidence of 1 in approximately 4,000 live births [6]. Dacryocystoceles are benign self-limited entities, and approximately 50 % of cases resolve in utero and 85 % resolve in the first year of life [1,2].…”

An urgent dacryocele

“…Dacryocele (or dacryocystocele), resulting from accumulation of fluid trapped within the lacrimal sac, complicates <1% of the infants affected 12. It is rarely sight threatening, and is usually managed conservatively by digital “Crigler” massage 3…”