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).