The authors report a series of 8 children presenting with a congenital nasolacrimal duct cyst and dacryocoele and highlight the importance of endoscopic nasal examination of newborns presenting with respiratory problems. [ncbi.nlm.nih.gov]

The presentation is common early in infancy, typically 4 days to 10 weeks. Infants present with small round bluish medial canthus mass identified at birth or shortly after +/- distal intra-nasal cystic lesion causing nasal obstruction. [radiopaedia.org]

Unilateral cases present with unilateral nasal obstruction and rhinorrhea. Bilateral cases present with severe respiratory distress requiring prompt intervention. [csurgeries.com]

All patients were 2 years old or younger presented with persistent epiphora since birth with sticky eyes. All had normal development with no other past medical history of note. [link.springer.com]

Discussion Presentation of congenital dacryocystocele Congenital dacryocystocele, also known as a dacryocele, often presents shortly after birth. [webeye.ophth.uiowa.edu]

• Poor Feeding

  His respiratory distress increased with feeding, and he was feeding poorly. His arterial blood gas level was normal. [thefreelibrary.com]

• Feeding Difficulties

  Basic Info The patient is a 4 week old female infant with right sided epiphora and complete right sided nasal obstruction resulting in respiratory and feeding difficulty. [csurgeries.com]

• Mucosal Edema

  Nasal endoscopy at 3 days of age revealed nasal mucosal edema and mild right choanal stenosis. He was treated with nasal oxymetazoline drops, and his respiratory symptoms resolved. [healio.com]

• Intravenous Administration

  administration of contrast material may demonstrate slight enhancement of the cyst wall that is more pronounced in dacryocystitis. [radiopaedia.org]

• Respiratory Distress

  His respiratory distress increased with feeding, and he was feeding poorly. His arterial blood gas level was normal. [thefreelibrary.com]

  Nasolacrimal duct abnormality should be considered in the differential diagnosis of neonatal respiratory distress and nasal obstruction. Nasal endoscopy is essential in the work-up of all children with nasal obstruction and respiratory distress. [ncbi.nlm.nih.gov]

  Bilateral nasolacrimal duct mucocele, a rare cause of respiratory distress: CT findings in two newborns. AJNR Am J Neuroradiol. 1993 Jul-Aug;14(4):1011-3. Meyer JR, Quint DJ, Holmes JM, Wiatrak BJ. [roentgenrayreader.blogspot.com]

• Labored Breathing

  Because infants are preferential nose breathers, this displacement can cause significant respiratory distress, manifested as cyanosis, labored breathing, and poor feeding. (4) These symptoms usually diminish with crying, and they can be temporarily relieved [thefreelibrary.com]

• Tachypnea

  On admission, the infant had increased work of breathing including tachypnea, nasal flaring and retractions. On the initial chest radiograph, the NG tube was not seen even though it was in the left nare at 10 cm. [nature.com]

• Respiratory Insufficiency

  Associated intranasal cyst (Fig. 12.7 ) can be small or large (if >50 of the nasal cavity) and, if large, can cause respiratory insufficiency because infants are nasal breathers, which can be life-threatening in cases of bilateral pathology [ 11 ]. [entokey.com]

• Cyanosis

  Because infants are preferential nose breathers, this displacement can cause significant respiratory distress, manifested as cyanosis, labored breathing, and poor feeding. (4) These symptoms usually diminish with crying, and they can be temporarily relieved [thefreelibrary.com]

• Anisocoria

  No anisocoria and no relative afferent pupillary defect Intraocular pressure: Physiologic by palpation Alignment : Ortho by Hirschberg Anterior segment exam : Within normal limits Dilated funduscopic exam : Deferred until examination under anesthesia [webeye.ophth.uiowa.edu]

• Impulsivity

  Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years C. Some impairment from the symptoms is present in two or more settings (eg, at school (or work) and at home) D. [books.google.com]

Neoplasm [ edit ] Neoplasm should be considered in any patient presenting with NLD obstruction.In patients with an atypical presentation, including younger age and male gender, further workup is appropriate. [en.wikipedia.org]

• Periostal Elevation

  The inferior turbinate was infractured using a Freer periosteal elevator if additional space was required. Following marsu piali zation of the cyst, the Bowman probe was visualized coming through the distal valve of Hasner (Fig 4C). [healio.com]

  Freer’s periosteal elevator depending on the view and space available for manipulation in the inferior meatus. [djo.org.in]

Conclusions Microdebrider assisted endoscopic marsupialisation is a safe and effective treatment for removal of excess tissue in the treatment for congenital intranasal NLD cyst/inferior mucocoele whilst also obviating the need for silastic intubation [link.springer.com]

Treatment and prognosis Treatment of dacryocystoceles is graded and ranges from manual pressure to probing with irrigation to endoscopic resection and marsupialization in severe cases. [radiopaedia.org]

Her symptoms had largely resolved following treatment with intravenous antibiotics for 2 days followed by treatment at home with oral and topical antibiotics. She was otherwise healthy. [healio.com]

Early diagnosis and treatment of this condition is critical in the infant with nasal obstruction. [ncbi.nlm.nih.gov]

Sepsis is a life threatening complication if the infection goes without treatment. [webeye.ophth.uiowa.edu]

Treatment and prognosis Treatment of dacryocystoceles is graded and ranges from manual pressure to probing with irrigation to endoscopic resection and marsupialization in severe cases. [radiopaedia.org]

(Outcomes/Resolutions) Overall, the prognosis of Blocked Tear Duct is very good with appropriate therapy. In infants, usually, the blocked duct gets better by its own. [dovemed.com]

Prognosis : dependent upon primary cause. [vetstream.com]

Prognosis Overall prognosis is excellent. More than 90% of children with these developmental anomalies have improved subjective tearing postoperatively. Moscato EE, Kelly JP, Weiss A. [emedicine.medscape.com]

[…] extraorally Presentation could result in clinical differential diagnosis of odontogenic infection Intraorally, obliterates the mucolabial fold 10% of cysts are bilateral Diagnosis Diagnosis dependent of clinical, radiologic and pathologic correlation Prognosis [pathologyoutlines.com]

Embryology Etiology / Pathogenesis Ultrasound Differential Diagnosis [fetalultrasound.com]

The etiology is obstruction at the level of Hassner's valve. Advanced Procedure 1. Lidocaine with epinephrine pledgelets are placed in the nasal cavity around the nasal mass and inferior turbinate 2. [csurgeries.com]

Acquired lacrimal drainage obstruction: An etiologic classification system, case reports, and a review of the literature. Ophthal Plast Reconstr Surg.1992;8:237-49. 2. Alexandrakis G, Hubbell RN, Aitken PA. [ijo.in]

Pathogenesis Etiology Internal Dacryocystitis Eye: dacryocystitis - inflammation of the nasolacrimal sac and duct often secondary to: Foreign bodies, eg plant material and dust/debris Conjunctivitis: foreign body. [vetstream.com]

Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Part 2. Ophthal Plast Reconstr Surg. 1992. 8(4):243-9. [Medline]. Bartley GB. [emedicine.medscape.com]

In this article, we shall briefly review the epidemiology, clinical presentation and the common causes of this condition. Epidemiology Clinical research has shown that nasolacrimal duct obstruction occurs in 2 to 4 out of 100 newborn babies. [eyeplastics.com]

Diagnosis: Congenital Dacryocystocele Epidemiology Presents within first several days to weeks of life (median age = 7 days of life)[2] Usually unilateral Signs Elevated purplish mass inferior to medial canthal tendon Epiphora, mattering (generally unilateral [webeye.ophth.uiowa.edu]

Definition / general A rare, developmental non-odontogenic cyst that occurs in the soft tissues of the upper lip lateral to midline Terminology Klestadt cyst Nasal alveolar cyst Nasoalveolar cyst Nasal wing cyst Nasal vestibule cyst Mucoid cyst of the nose Epidemiology [pathologyoutlines.com]

Pathophysiology Canalization of the nasolacrimal duct system usually is complete by the eighth month of gestation; problems in this normal developmental process can cause any of the above anomalies. [1] Epidemiology Frequency United States Nasolacrimal [emedicine.medscape.com]

Pathophysiology Stenosis and/or occlusion of the nasolacrimal duct system may occur as an acquired complication of various disease processes within the drainage system or external to it. [vetstream.com]

Pathophysiology Canalization of the nasolacrimal duct system usually is complete by the eighth month of gestation; problems in this normal developmental process can cause any of the above anomalies. [1] Epidemiology Frequency United States Nasolacrimal [emedicine.medscape.com]

Pathophysiology/Statistics Although quite common, the frequency of nasolacrimal drainage obstruction is unknown. It has no racial predilection. PANDO is more commonly seen in middle-aged and elderly females. [eyeplastics.com]

The procedure with the microdebrider was carefully performed to prevent injury to the surrounding tissue. Nasal packing to prevent bleeding was not necessary. [jstage.jst.go.jp]

Role of topical antibiotics: Topical antibiotics can be used to prevent secondary conjunctivitis. Warm compresses, lacrimal massage, probing of lacrimal duct can be performed to facilitate drainage of tears. [sites.google.com]

For the same reason when applying some eye drops it is often advised to close the nasolacrimal duct by pressing it with a finger to prevent the medicine from escaping the eye and having unwanted side effects elsewhere in the body. [en.wikipedia.org]

Blocked Tear Ducts are conditions that cannot be usually prevented. [dovemed.com]

Early treatment of a blocked duct may prevent the need for surgery. [kidshealth.org]