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Lotfi C, Ksouri S. [Congenital dacryocystocele complicated by respiratory distress in a newborn: A case report]. J Fr Ophtalmol 2023; 46:e157-e159. [PMID: 37085373 DOI: 10.1016/j.jfo.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/06/2022] [Accepted: 06/11/2022] [Indexed: 04/23/2023]
Affiliation(s)
- C Lotfi
- Service d'ophtalmologie, hôpital régional de Kasserine, 1200 Kasserine, Tunisie; Faculté de médecine de Sousse, Sousse, Tunisie.
| | - S Ksouri
- Service d'ophtalmologie, hôpital régional de Kasserine, 1200 Kasserine, Tunisie; Faculté de médecine de Sousse, Sousse, Tunisie
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Rampinelli V, Ferrari M, Zorzi S, Berlucchi M. Treatment of congenital nasolacrimal duct cyst: the role of endoscopic marsupialisation. ACTA ACUST UNITED AC 2021; 40:377-382. [PMID: 33299228 PMCID: PMC7726643 DOI: 10.14639/0392-100x-n0759] [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] [Received: 03/23/2020] [Accepted: 05/21/2020] [Indexed: 11/23/2022]
Abstract
Objective Congenital nasolacrimal duct cyst (NLDC) is a rare disorder, which can present with ophthalmological and nasal signs and symptoms. The authors analyse their personal experience to identify diagnostic criteria for NLDC, which were treated by endoscopic transnasal procedure. Methods Clinical records of patients with a diagnosis of NLDC were retrospectively reviewed. All patients underwent rhinoscopy and ophthalmologist evaluation before surgery, whereas imaging was performed in selected cases. All neonates underwent transnasal endoscopic marsupialisation after failure of conservative medical therapy. Results Five patients were included in the study. One patient presented bilateral NLDC. In 3 cases, CT scan of the sinus was carried out. A total of 6 marsupialisation procedures were performed and a bi-canalicular lacrimal stent was positioned in 1 case. Complete remission of symptoms was observed in all cases. Conclusions Nasal endoscopy is mandatory to diagnose NLDCs, and, in some cases, it can be complemented by radiological procedures. When symptoms persist after systemic and topical therapy, nasal endoscopic marsupialisation is the treatment of choice. This surgical procedure is effective, safe and can be repeated if needed.
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Affiliation(s)
- Vittorio Rampinelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, ASST Spedali Civili of Brescia, Italy
| | - Marco Ferrari
- Unit of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, ASST Spedali Civili of Brescia, Italy.,Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences; University of Padua, Italy
| | - Silvia Zorzi
- Unit of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, ASST Spedali Civili of Brescia, Italy
| | - Marco Berlucchi
- Unit of Pediatric Otorhinolaryngology, ASST Spedali Civili of Brescia, Italy
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Oueslati M, Mahjoub A, Khayrallah O, Sayehi B, Abdesslam NB, Knani L, Mahjoub H. [Congenital dacryocystocele in the newborn: Diagnosis and management]. J Fr Ophtalmol 2021; 44:e461-e463. [PMID: 33933311 DOI: 10.1016/j.jfo.2020.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M Oueslati
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, avenue Ibn-ElJazzar, 4000 Sousse, Tunisie.
| | - A Mahjoub
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, avenue Ibn-ElJazzar, 4000 Sousse, Tunisie.
| | - O Khayrallah
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, avenue Ibn-ElJazzar, 4000 Sousse, Tunisie.
| | - B Sayehi
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, avenue Ibn-ElJazzar, 4000 Sousse, Tunisie.
| | - N Ben Abdesslam
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, avenue Ibn-ElJazzar, 4000 Sousse, Tunisie.
| | - L Knani
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, avenue Ibn-ElJazzar, 4000 Sousse, Tunisie.
| | - H Mahjoub
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, avenue Ibn-ElJazzar, 4000 Sousse, Tunisie.
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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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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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Alakus MF, Dag U, Balsak S, Erdem S, Oncul H, Akgol S, Diri H. Is there an association between congenital nasolacrimal duct obstruction and cesarean delivery? Eur J Ophthalmol 2019; 30:1228-1231. [PMID: 31744323 DOI: 10.1177/1120672119889522] [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: 11/17/2022]
Abstract
PURPOSE The aim of this study was to research the relationship between types of birth and congenital nasolacrimal duct obstruction. METHOD The study enrolled 665 infantile patients with prediagnosis of congenital nasolacrimal duct obstruction due to associated ophthalmic symptoms. Age, gender, family history, delivery type, and patient medical records were investigated. Patients were grouped and compared according to their birth type and whether it was the first birth. RESULTS The number of the infants with and without congenital nasolacrimal duct obstruction was 227 (34.1%) and 438 (65.9%), respectively. Comparison of the congenital nasolacrimal duct obstruction and non-congenital nasolacrimal duct obstruction groups according to the first births showed that ratio of cesarean section was significantly higher in the congenital nasolacrimal duct obstruction group than the non- congenital nasolacrimal duct obstruction group (58.7% and 20.7%, respectively). Number with positive family history also was significantly higher in the congenital nasolacrimal duct obstruction group. CONCLUSION Cesarean section in first birth and positive family history of congenital nasolacrimal duct obstruction appear to be important risk factors in the etiopathogenesis of congenital nasolacrimal duct obstruction.
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Affiliation(s)
- Mehmet Fuat Alakus
- Department of Ophthalmology, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Umut Dag
- Department of Ophthalmology, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Selahattin Balsak
- Department of Ophthalmology, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Seyfettin Erdem
- Department of Ophthalmology, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Hasan Oncul
- Department of Ophthalmology, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Sedat Akgol
- Department of Obstetrics and Gynecology, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Halit Diri
- Department of Endocrinology and Metabolic Diseases, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
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Carneiro de Sousa P, Neves M, Duarte D, Azevedo P. Congenital bilateral dacryocystocele. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 136:41-42. [PMID: 30337239 DOI: 10.1016/j.anorl.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/27/2017] [Accepted: 10/03/2017] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Newborns are obligatory nasal breathers. Therefore, nasal obstruction can lead to cyanosis and desaturation. In spite of being very rare, congenital bilateral dacryocystocele is a possible etiology for neonatal respiratory distress. CASE SUMMARY Case report of a male newborn with respiratory distress caused by a bilateral polypoid and bluish lesion occupying almost the entire inferior nasal meatus. Imaging confirmed bilateral dacryocystocele. Treatment was conservative. There was spontaneous drainage, with relief of respiratory distress. Discussion The diagnosis of congenital dacryocystocele is clinical, although imaging exams may be requested to confirm it. Treatment is controversial, because the natural history is variable. An initial conservative management may be recommended, but, if there is a permanent respiratory obstruction without improvement, surgical management is mandatory.
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Affiliation(s)
- Pedro Carneiro de Sousa
- Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos Otorhinolaryngology, Travessa do Padre Amaro, number 169/229, Matosinhos 4455-033, Portugal.
| | - Marta Neves
- Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos Otorhinolaryngology, Travessa do Padre Amaro, number 169/229, Matosinhos 4455-033, Portugal
| | - Delfim Duarte
- Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos Otorhinolaryngology, Travessa do Padre Amaro, number 169/229, Matosinhos 4455-033, Portugal
| | - Paula Azevedo
- Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos Otorhinolaryngology, Travessa do Padre Amaro, number 169/229, Matosinhos 4455-033, Portugal
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Miranda-Rivas A, Villegas VM, Nieves-Melendez JR, De La Vega A. Congenital dacryocystocele: sonographic evaluation of 11 cases. J AAPOS 2018; 22:390-392. [PMID: 30227247 DOI: 10.1016/j.jaapos.2018.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 05/04/2018] [Accepted: 06/01/2018] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Angela Miranda-Rivas
- Department of Obstetrics and Gynecology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
| | - Victor M Villegas
- Department of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Jose R Nieves-Melendez
- Department of Obstetrics and Gynecology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Alberto De La Vega
- Department of Obstetrics and Gynecology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
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Syndromic and Nonsyndromic Systemic Associations of Congenital Lacrimal Drainage Anomalies: A Major Review. Ophthalmic Plast Reconstr Surg 2017; 33:399-407. [PMID: 28472008 DOI: 10.1097/iop.0000000000000923] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE To review and summarize the syndromic, nonsyndromic, and systemic associations of congenital lacrimal drainage anomalies. METHODS The authors performed a PubMed search of all articles published in English on congenital lacrimal anomalies (1933-2016). Patients of these articles were reviewed along with the literature of direct references to syndromes and other systemic associations. Data reviewed included syndromic descriptions, systemic details, demographics, lacrimal presentations, management, and outcomes. RESULTS Syndromic and systemic associations with congenital lacrimal drainage disorders are not known to be common. Although familial presentations have been reported, the inheritance patterns are unclear for most anomalies. There is an increasingly growing evidence of a genetic basis to many lacrimal anomalies. However, few syndromes have either widespread or are frequently associated with lacrimal anomalies. Few sequences of distinct lacrimal presentations and intraoperative findings are seen. Surgical challenges in these patients are distinct and a thorough pre and intraoperative anatomical assessment, detailed imaging when indicated, and assessment and correction of associated periocular and facial abnormalities may facilitate good outcomes. CONCLUSIONS Lacrimal drainage anomalies associated with syndromic and nonsyndromic systemic conditions have certain unique features of their own and their surgical and anesthesia challenges are distinct. Diagnosis of congenital lacrimal drainage anomalies should prompt consideration of the possible presence of associated systemic abnormalities.
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Başal Y, Akcan AB, Polat YD, Günel C, Eryilmaz A, Başak S. Rarely Seen Nasal Congenital Problems Causing Neonatal Upper Respiratory Obstruction: A Case Series. Pediatr Rep 2016; 8:6456. [PMID: 27114819 PMCID: PMC4821219 DOI: 10.4081/pr.2016.6456] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 02/16/2016] [Accepted: 02/18/2016] [Indexed: 11/22/2022] Open
Abstract
Since newborns are obligatory nasal breathers, upper respiratory tract problems may sometimes be life threatening. The most common pathology causing dyspnea and stridor in newborns is laryngomalacia. Nasal cavity pathologies that risk the neonatal airway are more rarely met. These anomalies may be seen either as solitary anomalies or as a part of a syndrome. While choanal atresia is one of the best-known nasal cavity anomalies, choanal stenosis, congenital nasal mid-line masses, congenital nasal pyriform aperture stenosis, and nasal tip anomalies are more rarely seen structural pathologies. Choanal atresia may be present either as an isolated congenital anomaly or as a part of CHARGE syndrome. Some rare chromosome anomalies may also cause significant problems during nasal respiration in newborns. With this study, we presented a case series of newborns with pathologies that affected nasal respiration. Although the diagnosis and treatment of choanal atresia and congenital dacryocystocele are well known, the information on the diagnosis and treatment of the other two uncommon cases are limited. With this study, we aimed to contribute to the literature by presenting our approach in six cases having congenital pathologies that cause nasal respiratory obstruction.
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Affiliation(s)
- Yeşim Başal
- Departments of Ear, Nose, Throat-Head and Neck Surgery, Faculty of Medicine, Adnan Menderes University , Aydın, Turkey
| | - Abdullah Bariş Akcan
- Departments of Pediatrics, Faculty of Medicine, Adnan Menderes University , Aydın, Turkey
| | - Yasemin Durum Polat
- Departments of Radiology, Faculty of Medicine, Adnan Menderes University , Aydın, Turkey
| | - Ceren Günel
- Departments of Ear, Nose, Throat-Head and Neck Surgery, Faculty of Medicine, Adnan Menderes University , Aydın, Turkey
| | - Aylin Eryilmaz
- Departments of Ear, Nose, Throat-Head and Neck Surgery, Faculty of Medicine, Adnan Menderes University , Aydın, Turkey
| | - Sema Başak
- Departments of Ear, Nose, Throat-Head and Neck Surgery, Faculty of Medicine, Adnan Menderes University , Aydın, Turkey
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Aldahash FD, Al-Mubarak MF, Alenizi SH, Al-Faky YH. Risk factors for developing congenital nasolacrimal duct obstruction. Saudi J Ophthalmol 2014; 28:58-60. [PMID: 24526860 PMCID: PMC3923192 DOI: 10.1016/j.sjopt.2013.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 09/29/2013] [Accepted: 09/30/2013] [Indexed: 12/05/2022] Open
Abstract
Objective To identify potential risk factors for developing congenital nasolacrimal duct obstruction (CNLDO). Study design and methods A cross-sectional study. A quantitative questionnaire was distributed to a sample of mothers attending the Pediatrics Clinic at King Khalid University Hospital, Riyadh, Saudi Arabia. Results A total of 756 mothers responded to our questionnaire. Of the 756 filled questionnaires, 389 (51.67%) were male children. 5.3% of the mothers lived in non-urban settings. CNLDO was reported in the children attending the clinic by 17.1% (129/756) of their mothers. Average age (±SD) of infants when persistent tearing was noticed was 3.2 ± 2.7 months, while average age (±SD) of resolution was 9.6 ± 3.7 months. Of the children with CNLDO, 37.2% (48/129) still have persistent tearing at the time of distributing the questionnaire. Among the group with CNLDO, 17% (22/129) of their mothers have experienced an infection during pregnancy (p = 0.022). Within the same group, 14.7% (19/129) of the affected children were reported by their mothers to have other children with CNLDO which was statistically significant (p = <0.001). Conclusion CNLDO could have a genetic predisposition and maternal infection is a possible risk factor for developing CNLDO. Surgical management awareness should be emphasized to relieve children from this relatively common and benign condition.
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Affiliation(s)
- Faisal D Aldahash
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad F Al-Mubarak
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad H Alenizi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yasser H Al-Faky
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Foster J, Kapoor S, Diaz-Horta O, Singh A, Abad C, Rastogi A, Moharana R, Tekeli O, Walz K, Tekin M. Identification of an IGSF3 mutation in a family with congenital nasolacrimal duct obstruction. Clin Genet 2013; 86:589-91. [PMID: 24372406 DOI: 10.1111/cge.12321] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/04/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
Affiliation(s)
- J Foster
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
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Yoo SW, Jeong HM, Lee SH, Lee JH. A case of congenital heminasal hypoplasia with an intranasal cyst: an extremely rare occurrence. Int J Pediatr Otorhinolaryngol 2013; 77:585-7. [PMID: 23369613 DOI: 10.1016/j.ijporl.2012.12.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 12/14/2012] [Accepted: 12/18/2012] [Indexed: 11/28/2022]
Abstract
Various congenital nasal deformities can occur because of the complexities of the developmental process. These conditions range from partial deformities of the nose (such as isolated absence of the nasal bones, absence of columella, absence of the septal cartilage, and absence of vomeral bone) to complete absence of the nose. Congenital heminasal hypoplasia is an extremely rare defect of embryogenesis. We present a case of congenital heminasal hypoplasia with an associated dacryocystocele and intranasal cyst. The treatment of congenital dacryocystocele remains controversial. The majority of researchers recommend an initial treatment plan that does not include surgical intervention. Surgical reconstruction of the external nose and inner cavities can be delayed at least until the preschool years, when facial development is nearly complete.
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Affiliation(s)
- Sang-Woo Yoo
- Department of Otolaryngology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Chonbuk, South Korea
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