Two Cases of Nasolacrimal Duct Cyst Developed in Neonate

Bilateral nasolacrimal duct cyst is an uncommon disease causing respiratory and feeding difficulty in neonates. It can either present pure intranasal cystic mass or be associated with dacryocystocele and/or dacryocystitis. Symptoms and signs of nasolacrimal duct cyst are different according to the patient's age and its bilaterality. Therefore, treatment should be individualized according to its presentation. The authors experienced one case of bilateral nasolacrimal duct cyst without dacryocystocele which caused respiratory difficulty and another case of nasolacrimal duct cyst associated with dacryocystocele. Both cases were treated by endoscopic marsupializaion of the cysts. We report these two cases with a brief review of the literature.

A Case of Bilateral Congenital Nasolacrimal Duct Cysts Presenting as Neonatal Respiratory Distress / 대한주산의학회잡지

Congenital nasolacrimal duct cyst is an uncommon anomaly of nasolacrimal duct obstruction in the newborn. It is cystic dilation of the lower end of the unperforated nasolacrimal duct with intranasal extension. In such cases, the bluish-gray cyst arises beneath the inferior turbinate on nasal endoscopy. A large nasolacrimal duct cyst can fill the nasal cavity and lead to nasal obstruction. Neonates are obligate nasal breathers at birth and require several weeks to learn to breathe through the mouth. Consequently this nasal obstruction can cause significant respiratory distress. We experienced a case of bilateral nasolacrimal duct cyst presenting as neonatal respiratory distress. Diagnosis was confirmed by nasal endoscopy and CT scan. After endoscopic marsupialization of the cysts , symptom and sign of respiratory distress were rapidly resolved.

A Case of Bilateral Congenital Dacryocystoceles with Nasolacrimal Duct Cysts

PURPOSE: Congenital dacryocystocele is an uncommon variant of congenital nasolacrimal duct obstruction. We report a case of infected congenital dacryocystoceles with nasolacrimal duct cysts bilaterally. METHODS: A 5-day-old girl had bilateral bluish swellings over the lacrimal sacs. Although she had been treated with systemic antibiotics, antibiotic eyedrops and massage, the swelling was not reduced. A computed tomographic (CT) scan demonstrated distension of both lacrimal sacs and nasolacrimal ducts with soft tissue masses beneath the inferior turbinates bilaterally. RESULTS: After marsupialization of bilateral nasolacrimal duct cysts under nasal endoscopic visualization, the swellings over both lacrimal sacs were rapidly resolved without recurrence 3 months thereafter.

Dacryocystitis associated with nasolacrimal duct cyst

An infant presented with persistent epiphora after successful probing of the lacrimal system. Examination of the nose showed a cystic structure occluding lower portion of the lacrimal drainage system. In cases of recurrent obstruction, nasal examination and endoscopic marsupialization may help guide the clinician towards the most appropriate treatment.