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

Abstract

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.

Special congenital dacryocystocele

“…After confirming the diagnosis by lacrimal excretion test and radiological examination, the outcome of appropriate surgical treatment should be successful. [10][11][12] In this case, we found that the patient eventually underwent the "right eye and nose endoscopy" under the nasal endoscope. The symptoms of tears disappeared the next day after the operation.…”

“…After confirming the diagnosis by lacrimal excretion test and radiological examination, the outcome of appropriate surgical treatment should be successful. 10 - 12 …”

The epidemiology and the pathogen distribution of pediatric dacryocystitis in Chinese population 2017–2022

“…Congenital dacryocyst is a cyan cystic mass in the inner canthus of newborns, and is caused by obstruction at both ends of the diversion channel [ 6 ]. Some study reported that in children, nearly 60% of patients with congenital dacryocyst eventually develop a peri-dacryocyst infection [ 7 , 8 ]. Dacryocystitis is mainly caused by Gram-positive cocci, especially Streptococcus pneumoniae ; due to the misuse of anti-Gram-positive cocci antibiotics, Gram-negative Enterobacteriaceae have risen in the proportion of dacryocystitis pathogens [ 9 ].…”

The epidemiology and the pathogen distribution of pediatric dacryocystitis in Chinese population 2017-2022, a cohort study

“…Congenital dacryocyst is a cyan cystic mass in the inner canthus of newborns, and is caused by obstruction at both ends of the diversion channel, leading to dilation of the lacrimal sac, enlargement of the nasolacrimal duct, and the formation of a cystic mass in the nose 4 . Congenital dacryocystitis often develops into dacryocystitis or orbital cytitis, which can be life threatening 5 .Some study reported that in children, nearly 60% of patients with congenital dacryocyst eventually develop a peri-dacryocyst infection 6 . However, there is no data about the epidemiology of pediatric dacryocystitis and the distribution of dacryocystitis pathogens.…”