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Congenital Dacryocystocele: Diagnosis and Management

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Book cover Oculofacial, Orbital, and Lacrimal Surgery

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Abstract

Congenital dacryocystocele (or dacryocele, amniotocele) is the diffuse, nonneoplastic, cystic dilation of the lacrimal sac in newborns with congenital nasolacrimal duct obstruction (CNLDO) as a result of consequent functional obstruction of the proximal opening of the enlarging lacrimal sac.

The most encountered symptoms of dacryocystoceles in the newborn are epiphora and difficulty in breathing. Dacryocystitis is the most common complication. Other common complications are preseptal cellulitis, cutaneous fistulae, and formation of nasal cysts. Intraorbital extension of dacryocystoceles may rarely occur.

Diverticulae of the lacrimal drainage apparatus, supernumerary sacs, epidermoid and dermoid cysts, mucoceles of paranasal sinuses, anterior encephaloceles, vascular aneurysms, and neoplasms should be included in the differential diagnosis. Ultrasonography, computerized tomography scanning, and magnetic resonance imaging with or without dacryocystography are informative imaging modalities.

Spontaneous resolution is common. Manual pressure applied by an ophthalmology professional is the first-line intervention and may relieve blockage at the distal end of the lacrimal apparatus in the majority of infants with congenital dacryocystoceles. Probing, intubation of the lacrimal drainage system, and balloon dacryoplasty with marsupialization of the nasal cysts when detected are surgical interventions with high success rates. Dacryocystorhinostomy and reduction of the sac volume may be required in complicated cases. Rarely, conjunctivodacryocystorhinostomy is needed in patients with dacryocystoceles due to punctal and/or proximal lacrimal obstructions.

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The author has no financial interest in any of the materials or equipment mentioned in the chapter.

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Authors and Affiliations

  1. Rufus Eye Microsurgical Center, Ophthalmic Plastic and Reconstructive Surgery Division, Istanbul, Turkey

    Pelin Kaynak

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Editors and Affiliations

  1. Eyelid and Facial Plastic and Reconstructive Surgery and MediSpa, Diseases and Surgery of the Orbit & Lacrimal System Neuro-ophthalmology, Glenview/Chicago, IL, USA

    Adam J. Cohen

  2. Oculoplastics, Orbital, and Cosmetic Facial Surgery, University of Wisconsin, Madison Department of Ophthalmology and Visual Sciences, Madison, WI, USA

    Cat Nguyen Burkat

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Kaynak, P. (2019). Congenital Dacryocystocele: Diagnosis and Management. In: Cohen, A., Burkat, C. (eds) Oculofacial, Orbital, and Lacrimal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-14092-2_50

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  • DOI: https://doi.org/10.1007/978-3-030-14092-2_50

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