Congenital dacryocystocele: Retrospective evaluation of clinical features and treatment results

Purpose: To review the clinical features and treatment results of patients with congenital dacryocystocele. Materials and Methods: The medical records of patients with congenital dacryocystocele who were treated between January 1999 and August 2018 were reviewed. Recorded data included patient age, gender, clinical findings, treatment methods and results, complications, and the duration of follow-up. Patients with inadequate medical data or follow-up were excluded. Results: The study included 54 patients (median and mean age: 33,5 and 56 days; range: 2-390 days) of whom 39 were female (72,3%) and 15 were male (27,7%). Dacryocystocele was bilateral in 8 (%15) patients (n=62 eyes). At presentation acute dacryocystitis was present in 31 eyes (50%). Dacryocystocele resolved with conservative management (lacrimal massage and antibiotics) in 15 eyes (24%) while 47 eyes (76%) required surgical treatment. Forty of 47 eyes (%85) in which an intranasal examination was performed had an intranasal cyst. Surgical procedures included lacrimal probing (45 eyes), intranasal cyst marsupialization (39 eyes), external dacryocystorhinostomy (2 eyes). Nasolacrimal duct obstruction recurred in 2 eyes (%4) and required secondary surgery. The mean follow-up was 38 months (range: 1-162 months). Discussion: Congenital dacryocystocele is frequently associated with intranasal nasolacrimal cyst and complicated by acute dacryocystitis. Although responding to conservative management sometimes, most dacryocystocele require a surgical treatment. Recurrences of nasolacrimal obstruction or complications following lacrimal probing with cyst marsupialization are rare. Key Words: Congenital dacryocystocele, intranasal cyst, probing, cyst marsupialization