CASE REPORT
Dacryocystocele is a congenital condition secondary to a defective
canalization of the nasolacrimal duct involving the Rosenmuller and
Hasner valves [1], thus leading to the subsequent
formation of a blueish cystic mass located at the medial cantus with
possible extension to the nasal cavity under the inferior turbinate,
causing respiratory obstruction [1] in severe
cases. The first approach is usually a conservative treatment, while
surgery is required when respiratory symptoms occur[2]. We here describe the case of a 40-days’ old
male newborn with a huge right dacryocystocele (Fig.1, Video 1)
extending into the nasal cavity with a cystic mass arising from the
inferior meatus, deforming the inferior turbinate and completely
occupying the anterior part of the nasal cavity (Fig.2). The intranasal
cyst was successfully treated by means of a transnasal endoscopic
power-assisted marsupialization with microdebrider (Fig. 3a-b); at the
end of surgery, the nasolacrimal duct was cannulated to confirm its
patency (Fig. 3c-d). This minimally-invasive and atraumatic surgical
option allowed the complete marsupialization of the nasal part of the
cyst, with the subsequent resolution of respiratory symptoms and medial
cantus swelling (Fig. 4a). Follow-up at six months showed no signs of
recurrence (Fig. 4b).