Obstruction of the nasolacrimal duct can result in a dacrocystocele.
Patient selection: usually an infant less than 12 weeks of age. It is more common in Caucasians and in females.
Clinical findings:
(1) epiphora (overflow of tears onto the cheek)
(2) mucoid or mucopurulent drainage
(3) cystic bluish swelling in the medial canthal area
The changes are usually unilateral.
Complications:
(1) dacrocystitis (infection)
(2) nasal obstruction (due to intranasal extension of the cyst into nasopharynx)
(3) respiratory compromise due to the nasal obstruction in an obligate nasal breather
Management:
• Conservative management may be sufficient, with digital massage of the mass.
• Antibiotic therapy may be necessary for bacterial dacrocystitis.
• Probing of the duct or endonasal decompression of the cyst may be necessary.
• A patient who develops dacrocystitis or nasal obstruction is more likely to need some form of intervention.
