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Sasaki T, Matsumura N, Miyazaki C, Kamao T, Yokoi N, Fujimoto M, Hayami M, Iwasaki A, Mimura M, Murata A, Nakayama T, Shinomiya K, Tanaka H, Ueta Y. Congenital nasolacrimal duct obstruction: clinical guideline. Jpn J Ophthalmol 2024:10.1007/s10384-024-01064-4. [PMID: 39150609 DOI: 10.1007/s10384-024-01064-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/09/2024] [Indexed: 08/17/2024]
Affiliation(s)
- Tsugihisa Sasaki
- Sasaki Eye Clinic, 5-2-6 Mikunihigashi, Mikunicho, Sakai, Fukui, 913-0016, Japan.
- Department of Ophthalmology & Visual Science, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.
| | - Nozomi Matsumura
- Department of Ophthalmology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Chika Miyazaki
- Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Tomoyuki Kamao
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Fujimoto
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Oculofacial Clinic Kyoto, Kyoto, Japan
| | | | | | - Masashi Mimura
- Department of Ophthalmology, Toho University Sakura Hospital, Sakura, Japan
- Department of Ophthalmology, Hyogo Medical University, Nishinomiya, Japan
| | | | - Tomomichi Nakayama
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kayo Shinomiya
- Department of Ophthalmology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hiroshi Tanaka
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiki Ueta
- Eye Center, Shinseikai Toyama Hospital, Imizu, Japan
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Annac G, Yassa M. Is congenital dacryocystocele a benign, self-limited disorder? A review of the literature with four new cases. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:813-821. [PMID: 34235752 DOI: 10.1002/jcu.23037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/12/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
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.
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Affiliation(s)
- Gokce Annac
- Radiology Department, Bartin State Hospital, Bartin, Turkey
| | - Murat Yassa
- Department of Obstetrics and Gynecology, Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
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Story L, Knight CL, Ho A, Arulkumaran S, Matthews J, Lovell H, McCabe L, Byrne M, Egloff A, Jacques AET, Carmichael J, Hajnal J, Shennan A, Rutherford M. Maternal and fetal incidental findings on antenatal magnetic resonance imaging. Pediatr Radiol 2021; 51:1839-1847. [PMID: 34046707 PMCID: PMC8426300 DOI: 10.1007/s00247-021-05074-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/09/2020] [Accepted: 03/28/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) examinations are increasingly used in antenatal clinical practice. Incidental findings are a recognized association with imaging and although in some circumstances their identification can alter management, they are often associated with increased anxiety, for both patient and clinician, as well as increased health care costs. OBJECTIVE This study aimed to evaluate the incidence of unexpected findings in both the mother and fetus during antenatal MRI examinations. MATERIALS AND METHODS A retrospective study was undertaken over a five-year period at St.. Thomas' Hospital in London. Maternal incidental findings were recorded from all clinical reports of all fetal MRIs performed (for clinical reasons and in healthy volunteers) during this period. Fetal incidental findings were recorded only in cases where women with uncomplicated pregnancies were participating as healthy volunteers. RESULTS A total of 2,569 MRIs were included; 17% of women had maternal incidental findings. Of these, 1,099 were women with uncomplicated pregnancies who undertook research MRIs as healthy volunteers; fetal incidental findings were identified in 12.3%. CONCLUSION Incidental findings are a common occurrence in antenatal MRI. Consideration should be given to counseling women appropriately before imaging and ensuring that robust local protocols are in place for follow-up and further management of such cases.
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Affiliation(s)
- Lisa Story
- Department of Women and Children's Health, King's College London, 10th Floor North Wing, St. Thomas' Hospital, London, SE1 7EH, UK. .,Fetal Medicine Unit, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Caroline L. Knight
- Department of Women and Children’s Health, King’s College London, 10th Floor North Wing, St. Thomas’ Hospital, London, SE1 7EH UK ,Fetal Medicine Unit, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Alison Ho
- Department of Women and Children’s Health, King’s College London, 10th Floor North Wing, St. Thomas’ Hospital, London, SE1 7EH UK
| | | | | | - Holly Lovell
- Department of Women and Children’s Health, King’s College London, 10th Floor North Wing, St. Thomas’ Hospital, London, SE1 7EH UK
| | - Laura McCabe
- Centre for the Developing Brain, King’s College, London, London, UK
| | - Megan Byrne
- Fetal Medicine Unit, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Alexia Egloff
- Centre for the Developing Brain, King’s College, London, London, UK
| | | | - Jim Carmichael
- Department of Radiology, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Jo Hajnal
- Centre for the Developing Brain, King’s College, London, London, UK
| | - Andrew Shennan
- Department of Women and Children’s Health, King’s College London, 10th Floor North Wing, St. Thomas’ Hospital, London, SE1 7EH UK
| | - Mary Rutherford
- Centre for the Developing Brain, King’s College, London, London, UK
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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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Gupta M, Khan H, Gupta M. Bilateral Congenital Nasolacrimal Duct Cyst: A Rare Cause of Nasal Obstruction. Cureus 2020; 12:e8742. [PMID: 32714680 PMCID: PMC7377024 DOI: 10.7759/cureus.8742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Nasal obstruction in neonates often results in respiratory discomfort, as neonates are obligate nasal breathers. Congenital bilateral nasal obstruction is an emergency situation which is generally secondary to choanal atresia. Rarely bilateral nasolacrimal duct (NLD) cyst causing intranasal swelling may be the underlying etiology. Neonatal respiratory distress warrants immediate measures to secure the airway and prompt investigations to reach a diagnosis for a definitive management. We describe a case of two-day-old girl with intermittent breathing difficulty because of bilateral NLD cysts causing nasal obstruction. The patient improved with conservative medical management.
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Affiliation(s)
- Manish Gupta
- Otorhinolaryngology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, IND
| | - Habibulla Khan
- Otorhinolaryngology, Maharishi Markandeshwar Institute of Medical Science and Research, Ambala, IND
| | - Monica Gupta
- General Medicine, Government Medical College and Hospital, Chandigarh, IND
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6
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Ladeiras R, Nunes JS, Torres S, Duarte C, Pereira E, Rosmaninho A. An Ultrasound Diagnosis of a Congenital Periorbital Rare Condition. J Med Ultrasound 2020; 29:142-143. [PMID: 34377653 PMCID: PMC8330682 DOI: 10.4103/jmu.jmu_42_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/18/2020] [Accepted: 04/28/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Rita Ladeiras
- Department of Gynecology and Obstetrics, Hospital Senhora da Oliveira, Guimarães, Braga, Portugal
| | - Joana Sousa Nunes
- Department of Gynecology and Obstetrics, Hospital Senhora da Oliveira, Guimarães, Braga, Portugal
| | - Sílvia Torres
- Department of Gynecology and Obstetrics, Hospital Senhora da Oliveira, Guimarães, Braga, Portugal
| | - Carla Duarte
- Department of Gynecology and Obstetrics, Hospital Senhora da Oliveira, Guimarães, Braga, Portugal
| | - Elsa Pereira
- Department of Gynecology and Obstetrics, Hospital Senhora da Oliveira, Guimarães, Braga, Portugal
| | - Adosinda Rosmaninho
- Department of Gynecology and Obstetrics, Hospital Senhora da Oliveira, Guimarães, Braga, Portugal
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Abstract
PURPOSE To provide a systematic review of the literature on congenital dacryocystoceles (CDCs) and summarize their presentations, investigations, management, and outcomes. METHODS The authors performed a PubMed search of all articles published in English on CDCs. Data captured include demographics, clinical presentations, investigations, management modalities, complications, and outcomes. Fourteen major series (10 or more than 10 cases) and 89 isolated case reports/series on CDCs with a collective patient pool of 1,063 were studied in detail. Specific emphasis was laid on addressing the controversial issues including initial conservative versus surgical management and the role of endoscopic evaluation. RESULTS Numerous terminologies have been used to describe CDC. Congenital dacryocystoceles are rare variants of congenital nasolacrimal duct obstructions and comprise of 0.1% to 0.3% of all such cases. There is a female predilection (64.2%, 683/1,063) and the mean age at presentation is at 7 days of birth. Initial conservative treatment can be a viable option in the absence of an acute dacryocystitis or a respiratory distress. Endoscopy-assisted probing appears to have better outcomes as compared with the in-office probing. Congenital dacryocystoceles with acute dacryocystitis are preferably managed with intravenous antibiotics and an early probing under endoscopy guidance to avoid missing intranasal cysts. Marsupialization is the preferred technique in the management of intranasal cysts. Silicone intubation was rarely used and has no definitive indications. Dacryocystorhinostomy is very rarely needed in the management of CDC. CONCLUSIONS Congenital dacryocystocele is a commonly accepted term and its use should be advocated to enhance uniformity in reporting. Endoscopic evaluation of CDC is useful in the diagnosis and treatment of associated intranasal cysts and enhances the rates of successful outcomes.
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A Comprehensive Review of Cross-Sectional Imaging of the Nasolacrimal Drainage Apparatus: What Radiologists Need to Know. AJR Am J Roentgenol 2019; 213:1331-1340. [PMID: 31483141 DOI: 10.2214/ajr.19.21507] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE. The purpose of this study is to provide a comprehensive review of the radiographic anatomy and cross-sectional imaging findings of the full gamut of nasolacrimal drainage apparatus diseases, highlighting imaging findings from the different nasolacrimal drainage apparatus surgeries, posttreatment complications, and potential imaging pitfalls. CONCLUSION. Radiologists play a critical role in guiding the management of nasolacrimal drainage apparatus diseases and should be familiar with the anatomy and characteristic imaging findings of commonly encountered nasolacrimal drainage apparatus abnormalities and surgeries.
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Ondeck CL, Pretorius D, McCaulley J, Kinori M, Maloney T, Hull A, Robbins SL. Ultrasonographic prenatal imaging of fetal ocular and orbital abnormalities. Surv Ophthalmol 2018; 63:745-753. [PMID: 29705173 DOI: 10.1016/j.survophthal.2018.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 11/15/2022]
Abstract
Technological progress in medicine has provided earlier diagnosis, even into the prenatal period. We address ultrasonographic imaging of the prenatal eye and orbit. During development of these structures, multiple pathologies and diseases can arise. Orbital anomalies can be detected prenatally using ultrasound or magnetic resonance imaging. Some of these include congenital cataracts, hypertelorism, hypotelorism, dacryocystocele, microphthalmia, anophthalmia, orbital tumors/masses, and septo-optic dysplasia. We describe characteristic ultrasound findings of these diseases. Prenatal ocular and orbital diagnosis is best facilitated by a team approach between ophthalmology, radiology, obstetrics, neonatology, and genetic counselors to optimize diagnostic accuracy, familial expectations, and early treatment.
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Affiliation(s)
- Courtney L Ondeck
- Ratner Children's Eye Center at the Shiley Eye Institute, University of California, San Diego, California, USA
| | - Dolores Pretorius
- Maternal Fetal Care and Genetics Center, University of California, San Diego, California, USA; Department of Radiology, University of California, San Diego, California, USA
| | - Jill McCaulley
- Maternal Fetal Care and Genetics Center, University of California, San Diego, California, USA; Department of Reproductive Medicine, University of California, San Diego, California, USA
| | - Michael Kinori
- Ratner Children's Eye Center at the Shiley Eye Institute, University of California, San Diego, California, USA
| | - Theresa Maloney
- Maternal Fetal Care and Genetics Center, University of California, San Diego, California, USA; Department of Radiology, University of California, San Diego, California, USA
| | - Andrew Hull
- Maternal Fetal Care and Genetics Center, University of California, San Diego, California, USA; Department of Radiology, University of California, San Diego, California, USA
| | - Shira L Robbins
- Ratner Children's Eye Center at the Shiley Eye Institute, University of California, San Diego, California, USA.
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Ali MJ, Singh S, Naik MN. Long-term outcomes of cruciate marsupialization of intra-nasal cysts in patients with congenital dacryocele. Int J Pediatr Otorhinolaryngol 2016; 86:34-6. [PMID: 27260576 DOI: 10.1016/j.ijporl.2016.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the long-term outcomes of cruciate marsupialization of intranasal cysts associated with congenital dacryocele. METHODS This is a retrospective review of 15 patients of dacryoceles with intranasal cysts who underwent cruciate marsupialization of the medial wall of the cyst. Post-operative follow up for a minimum of 9 months was an inclusion criterion for analysis. Data analyzed include demographics, clinical presentations, previous interventions, associated systemic abnormalities, clinical course following marsupialization and recurrences. Primary outcome measures were resolution of the dacryocele and symptomatic relief from epiphora. RESULTS The mean age at presentation was 1.6 months with a female preponderance (60%). History of prematurity (pre-term) was noted in 20% (3/15). Swelling in the lacrimal sac area (dacryocele) was the universal presentation. Five patients (33.3%) had a prior conservative treatment. Four patients (26.6%) had respiratory distress with feeding. Acute dacryocystitis was noted in 26.6% (4/15). At a mean follow up of 19.1 months, successful outcomes were achieved in 86.6%. CONCLUSION Cruciate marsupialization of intranasal cysts achieves good results in patients with congenital dacryocele, which are maintained over a long period of time. Early diagnosis and management may prevent acute dacryocystitis in these patients.
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Affiliation(s)
- Mohammad Javed Ali
- The Institute of Dacryology, L.V.Prasad Eye Institute, Hyderabad, India.
| | - Swati Singh
- The Institute of Dacryology, L.V.Prasad Eye Institute, Hyderabad, India
| | - Milind N Naik
- The Institute of Dacryology, L.V.Prasad Eye Institute, Hyderabad, India
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Oliveira GN, Branco M, Ramos L, Pereira DF. Congenital dacryocystocoele with prenatal diagnosis. BMJ Case Rep 2016; 2016:bcr-2016-215641. [PMID: 27166005 DOI: 10.1136/bcr-2016-215641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
| | - Miguel Branco
- Department of Gynaecology and Obstetrics, Maternidade Bissaya Barreto, Coimbra, Portugal
| | - Lina Ramos
- Department of Medical Genetics, Hospital Pediátrico de Coimbra, Portugal
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