Sonographic antenatal diagnosis of congenital dacryocystoceles

Is congenital dacryocystocele a benign, self-limited disorder? A review of the literature with four new cases

Congenital dacryocystocele (CD) is a rare disorder about which little is known. A nonsystematic review was performed with an addition of four new cases. Thirty-seven studies were reviewed. The mean gestational age at evaluation was 32 ± 1.09 weeks suggesting that CD is a disorder of late second and third trimester. The mean diameter of dacryocystocele was 7.5 ± 1 mm. The overall associated fetal anomaly rate was 10.7%. In-utero resolution, neonatal resolution, and surgical management was concluded in 62% (n = 108), 29% (n = 52), and 8% (n = 14), respectively. In conclusion, the need for surgical correction and rate of accompanying fetal anomaly was found high.

Congenital dacryocystocele: sonographic evaluation of 11 cases

PURPOSE

To report prenatal sonographic findings of congenital dacryocystocele.

METHODS

The medical records of all cases diagnosed with congenital dacryocystocele at a tertiary care center from 2003 to 2015 were reviewed retrospectively.

RESULTS

Eleven cases of congenital dacryocystocele were analyzed. No accompanying fetal anatomic anomalies where detected. Mean maternal age at evaluation was 22 years of age (range, 17-32 years). Four of 10 cases were primigravidas. The mean gestational age at evaluation was 32.6 weeks' gestational age. Ten out of 11 cases occurred in female fetuses (91%). Of the 11, 10 cases were unilateral and 1 was bilateral. The mean diameter at evaluation was 5.1 mm. Spontaneous resolution occurred in 2 cases (18%). In the remaining 9 fetuses, postnatal diagnosis of dacryocystocele were confirmed by an ophthalmologist evaluation.

CONCLUSIONS

Prenatally diagnosed congenital dacryocystocele may undergo spontaneous resolution before birth. However, a better understanding of the prenatal sonographic findings can help to appropriately orient parents of potentially affected fetuses. Referral to a pediatrician and pediatric ophthalmologist may be considered for complete evaluation and postnatal management.

Dacryocystocele on prenatal ultrasonography: diagnosis and postnatal outcomes

Purpose:

To report the incidence of dacryocystoceles detected by prenatal ultrasonography (US) and their postnatal outcomes and to determine the factors associated with the postnatal persistence of dacryocystoceles at birth.

Methods:

We retrospectively reviewed the prenatal US database at our institution for the period between January 2012 and December 2013. The medical records of women who had fetuses diagnosed with dacryocystocel larger than 5 mm were reviewed for maternal age, gestational age (GA) at detection, size and side of the dacryocystoceles, delivery, and postnatal information, such as GA at delivery, delivery mode, and gender of the neonate.

Results:

A total of 49 singletons were diagnosed with a dacryocystocele on prenatal US, yielding an overall incidence of 0.43%. The incidence of dacryocystoceles was the highest at the GA of 27 weeks and decreased toward term. Of the 49 fetuses including three of undeter mined gender, 25 (54%) were female. The mean GA at first detection was 31.2 weeks. The dacryocystocele was unilateral in 29 cases, with a mean maximum diameter of 7 mm. Spontaneous resolution at birth was documented in 35 out of 46 neonates (76%), including six with prenatal resolution. Multivariate analysis demonstrated that GA at delivery was a significant predictor of the postnatal persistence of dacryocystoceles (P=0.045).

Conclusion:

The overall incidence of prenatal dacryocystoceles was 0.43%; the incidence was higher in the early third trimester and decreased thereafter. Prenatal dacryocystoceles resolved in 76% of the patients at birth, and the GA at delivery was a significant predictor of postnatal persistence.