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Nakamura J, Ohno T, Inoue M, Takeuchi M, Mizuki N, Matsumura N. Otoscopy-assisted intranasal cyst marsupialization for congenital dacryocystocele. J AAPOS 2024; 28:103859. [PMID: 38438072 DOI: 10.1016/j.jaapos.2024.103859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/16/2023] [Accepted: 11/30/2023] [Indexed: 03/06/2024]
Abstract
We describe 3 infants with congenital dacryocystocele resistant to conservative treatment who were treated with a novel, simple intranasal cyst marsupialization (ICM) technique. Otoscopy-guided ICM was performed by an otolaryngologist in the manner of otoscopic myringotomy for cases with nasal cyst distension. All 3 infants were treated successfully by a single surgical procedure under topical anesthesia in an office setting.
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Affiliation(s)
- Jutaro Nakamura
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan; Department of Ophthalmology, Kanagawa Children's Medical Center, Mutsukawa, Yokohama, Kanagawa, Japan.
| | - Tomoko Ohno
- Department of Ophthalmology, Kanagawa Children's Medical Center, Mutsukawa, Yokohama, Kanagawa, Japan
| | - Maki Inoue
- Department of Otolaryngology, Kanagawa Children's Medical Center, Mutsukawa, Yokohama, Kanagawa, Japan
| | - Masaki Takeuchi
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Nozomi Matsumura
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan; Department of Ophthalmology, Kanagawa Children's Medical Center, Mutsukawa, Yokohama, Kanagawa, Japan
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Li Y, Wei M, Liu X, Zhang L, Song X, Xiao C. Dacryoendoscopy-assisted incision of Hasner's valve under nasoendoscopy for membranous congenital nasolacrimal duct obstruction after probing failure: a retrospective study. BMC Ophthalmol 2021; 21:182. [PMID: 33866971 PMCID: PMC8054357 DOI: 10.1186/s12886-021-01948-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
Background To introduce a treatment option: dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy and assess its efficacy in treating membranous congenital nasolacrimal duct obstruction (CNLDO) in children older than 1 year with history of initial probing failure. Methods 52 eyes of 43 children with membranous CNLDO who underwent dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy between May 2012 and October 2020 were enrolled in this retrospective study. All participants were older than 1 year and all the eyes had gone through probing at least once but still had symptoms of epiphora and discharge. Surgical success was defined as a normal fluorescein dye disappearance test (FDDT) and the absence of pre-operation complaints, including epiphora, muco-purulent discharge, increased tear lake or the symptoms of acute infection such as acute dacryocystitis. Patients’ demographics, clinical features and follow-up outcomes were evaluated. Results Of all these operated cases, surgical success was achieved in 52/52 eyes without any early or late complications. The overall success rate was 100%. Conclusions Dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy is an effective and minimally invasive surgical treatment in membranous CNLDO patients with initial probing failure.
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Affiliation(s)
- Yue Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Min Wei
- Handan Eye Hospital, Handan City, Hebei Province, China
| | - Xueru Liu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Leilei Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xuefei Song
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Caiwen Xiao
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Akpolat C, Sendul SY, Unal ET, Karatas E, Ucgul Atilgan C, Demir M. Outcomes of lacrimal probing surgery as the first option in the treatment of congenital dacryocystocele. Ther Adv Ophthalmol 2021; 13:25158414211030427. [PMID: 34291188 PMCID: PMC8274130 DOI: 10.1177/25158414211030427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/16/2021] [Indexed: 12/03/2022] Open
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.
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Affiliation(s)
- Cetin Akpolat
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Street Sisli, Istanbul 34280, Turkey
| | - Selam Yekta Sendul
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ebru Turkoglu Unal
- Department of Neonatology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Egemen Karatas
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Cemile Ucgul Atilgan
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Altındag, Ankara, Turkey
| | - Mehmet Demir
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Kono S, Lee PAL, Kakizaki H, Takahashi Y. Dacryoendoscopic examination for location of internal orifice of congenital lacrimal fistula: A case series. Int J Pediatr Otorhinolaryngol 2020; 139:110408. [PMID: 33017665 DOI: 10.1016/j.ijporl.2020.110408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
We examined the location of the internal orifice of congenital lacrimal fistula using a dacryoendoscope in 5 patients. A suture inserted from the skin orifice and passing into the lacrimal drainage system through the fistula track was identified using a dacryoendoscope. Consequently, the suture passed into the lacrimal sac in all patients. Although the internal orifice had been reported to be predominantly located in the common canaliculus, the methods previously used for identification of the internal orifice were less accurate. The results in our study suggest a higher incidence of congenital lacrimal fistulae connected with the lacrimal sac.
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Affiliation(s)
- Shinjiro Kono
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan
| | - Patricia Ann L Lee
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan
| | - Hirohiko Kakizaki
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan
| | - Yasuhiro Takahashi
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan.
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Biadsee A, Dagan O, Kassem F, Ben-Dov T, Ebner Y. Endoscopic marsupialization of nasolacrimal duct cysts under topical anaesthesia: 5 years of a single institute experience. Int J Pediatr Otorhinolaryngol 2020; 138:110303. [PMID: 32805492 DOI: 10.1016/j.ijporl.2020.110303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To present the outcomes of neonatal nasolacrimal duct cysts treated through endoscopic intranasal marsupialization under topical anaesthesia. METHODS A retrospective study of 19 infants diagnosed with congenital nasolacrimal duct cyst, with or without dacryocystocele, diagnosed and treated between March 2015 through March 2020. Data were extracted for descriptive purposes and included: birth weight, main presenting symptom, stertor or dyspnoea, unilateral or bilateral occurrence. Follow-up one month after intervention included recurrence of symptoms, physical examination and fibreoptic naso-endoscopy. RESULTS Nineteen infants with intranasal cyst were presented to our department at the age of 1 day. Four-teen infants had unilateral and 5 infants had bilateral intranasal cysts. There were 8 boys and 11 girls. Mean gestational age at birth was 39 weeks, mean birth weight was 3351 g. 42.1% of infants presented with dacryocystocele, 31.5% with stertor, and 26.3% with dyspnoea. 80% of infants with bilateral cysts presented with dyspnoea. Follow up ranged from 6 to 48 months, no recurrence of symptoms was reported. CONCLUSION Intranasal endoscopic marsupialization under topical anaesthesia is a successful, safe, low cost procedure for treating neonatal nasolacrimal duct cysts while avoiding general anaesthesia for infants.
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Affiliation(s)
- Ameen Biadsee
- Department of Otorhinolaryngology, Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Or Dagan
- Department of Otorhinolaryngology, Head and Neck Surgery, Hillel Yaffe Medical Center, Hadera, Israel.
| | - Firas Kassem
- Department of Otorhinolaryngology, Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Tom Ben-Dov
- Department of Otorhinolaryngology, Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Yaniv Ebner
- Department of Otorhinolaryngology, Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Gupta N, Singla P, Kumar S, Ganesh S, Dhawan N, Sobti P, Aggarwal S. Role of dacryoendoscopy in refractory cases of congenital nasolacrimal duct obstruction. Orbit 2019; 39:183-189. [PMID: 31552767 DOI: 10.1080/01676830.2019.1668434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To highlight the importance of dacryoendoscopy in recognizing the factors responsible for failure with successful recanalization obviating the need for dacryocystorhinostomy in a few selective cases.Method: A retrospective study of 13 children undergoing dacryoendoscopy for refractory congenital nasolacrimal duct obstruction (CNLDO) was carried out during a period of 3 years from 2016 to 2018. Children with single or multiple failed probings were included in the study.Results: Out of the total 13 cases included in the study there 9 males and 4 females. The age ranged from 9 months to 36 months with the involvement of the right side in 7 cases and the left side in 6 cases. Four cases had dysgenesis of bony nasolacrimal duct (NLD), 4 cases had dacryolith, 3 cases had an intact membrane at the lower end of NLD and 2 cases had fibrosis of the lower end of NLD and the surrounding area in the inferior meatus (IM) following multiple interventions, (Table 1). Dacryoendoscopic recanalization was done in 7 cases while the endoscopic dacryocystorhinostomy (DCR) was done in 6 cases. Asuccessful outcome was achieved in all the cases and at the end of 6 months, all the children remained asymptomatic.Conclusions: Dacryoendoscopy (DEN) facilitates direct examination of the nasolacrimal system and thus has an added advantage over nasal endoscopy assisted probing in the refractory cases of CNLDO.
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Affiliation(s)
- Nishi Gupta
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Poonam Singla
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Sunil Kumar
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Nidhi Dhawan
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Parul Sobti
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
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Zhao NW, Chan DK. Awake bedside nasal endoscopy for primary management of neonatal dacryocystoceles with intranasal cysts. Int J Pediatr Otorhinolaryngol 2019; 123:93-96. [PMID: 31085463 DOI: 10.1016/j.ijporl.2019.04.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/09/2019] [Accepted: 04/30/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To present outcomes of neonatal dacryocystoceles treated through endoscopic intranasal cyst marsupialization (EICM) without general anesthesia and nasolacrimal duct (NLD) probing or irrigation. METHODS Records of eleven consecutive infants diagnosed with unilateral or bilateral congenital cysts associated with the nasolacrimal system between January 2016 and February 2019 at our institution were retrospectively reviewed. RESULTS Age at diagnosis ranged from 0 to 56 days, and 45.5% were male. 54.5% had dacryocystitis before surgical intervention. Patients were initially treated with a combination of massage and topical antibiotics; some received parenteral antibiotics if infected. Nearly all patients (90.9%) had one or more intranasal cysts. Of these patients, two underwent lacrimal probing and EICM in the operating room. One underwent EICM only in the operating room. Another patient initially failed bedside NLD probing and subsequently underwent bedside nasal endoscopy and awake EICM. The final six patients underwent EICM without general anesthesia or NLD probing. No complications were noted. Follow-up ranged from 7 to 906 days. Complete resolution was observed in all ten patients who underwent EICM, regardless of anesthesia. CONCLUSIONS Neonatal dacryocystoceles and/or intranasal cysts are successfully treated at the bedside through nasal endoscopy with simple awake endoscopic intranasal cyst marsupialization. Avoidance of general anesthesia and NLD probing or irrigation would greatly simplify and decrease the cost of dacryocystocele management.
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Affiliation(s)
- Nina W Zhao
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA
| | - Dylan K Chan
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA.
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Kanshaiym S, El-Din MHN, Abdelazim IA, Hamed MES, Starchenko T. Congenital dilatation of the nasolacrimal sac (Dacryocystocele): Case report. J Family Med Prim Care 2019; 8:1284-1286. [PMID: 31041294 PMCID: PMC6482770 DOI: 10.4103/jfmpc.jfmpc_17_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Congenital dacryocystoceles are usually diagnosed in the third trimester by parental ultrasound as a cystic lesion adjacent to the medial and inferior aspects of the fetal orbit. A considerable number of dacryocystocele are bilateral and resolve spontaneously in utero and/or immediately after delivery. Persistent dacryocystoceles need ophthalmological consultation to avoid the possible potential complications. This case report represents a case of congenital dacryocystocele diagnosed by antenatal 2D and 3D ultrasounds, which disappeared spontaneously 2 days after birth. To highlight that, the diagnosis of congenital dacryocystoceles is important to avoid additional postnatal diagnostic techniques and to manage the potential postnatal complications.
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Affiliation(s)
- Sakiyeva Kanshaiym
- Department of Obstetrics and Gynecology №1, Marat Ospanov, West Kazakhstan State Medical University, Aktobe, Kazakhstan
| | | | - Ibrahim A. Abdelazim
- Ain Shams University, Cairo, Egypt
- Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait
| | | | - Tatyana Starchenko
- Department of Obstetrics and Gynecology №1, Marat Ospanov, West Kazakhstan State Medical University, Aktobe, Kazakhstan
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