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European Archives of... Oct 2021Congenital nasal obstruction can be a significant cause of respiratory distress in the newborn, given that they are considered to be obligate nasal breathers. Several... (Review)
Review
PURPOSE
Congenital nasal obstruction can be a significant cause of respiratory distress in the newborn, given that they are considered to be obligate nasal breathers. Several different causes have been described, which can be broadly classified as anatomical/malformative, non-tumoral masses and cysts, benign and malignant neoplasia, inflammatory/infectious, traumatic/iatrogenic, and miscellaneous. The purpose of this review is to provide updated and useful clinical information for teams involved in neonatal care, especially in a hospital setting.
METHODS
A review of the available literature was performed. Studies were sourced from PubMed with searching of relevant headings and sub-headings and cross-referencing.
RESULTS
The most common etiology is inflammatory, which can have different precipitating factors or be idiopathic, a condition known as neonatal rhinitis. On the other hand, some less frequent but nonetheless relevant conditions causing severe nasal obstruction include choanal atresia, midnasal stenosis, and pyriform aperture stenosis. Some cystic lesions, such as dacryocystoceles with intranasal mucocele, can also produce significant obstruction. Diagnosis usually requires a nasal endoscopy and in some cases imaging such as computed tomography. Management includes different medical and surgical strategies and will greatly depend on the etiology and the severity of symptoms.
CONCLUSION
Congenital nasal obstruction can be a significant cause of respiratory distress in the newborn. The wide spectrum of differential diagnoses requires a thorough knowledge of nasal anatomy, physiology, and pathology; as well as different management strategies.
Topics: Choanal Atresia; Humans; Infant, Newborn; Nasal Obstruction; Nose; Respiratory System Abnormalities; Rhinitis
PubMed: 33388986
DOI: 10.1007/s00405-020-06546-y -
Pakistan Journal of Medical Sciences 2023Congenital Dacryocystocele is a rare disease of the eye and nose, which originates from congenital obstruction of lacrimal duct system, but accounts for a low proportion...
Congenital Dacryocystocele is a rare disease of the eye and nose, which originates from congenital obstruction of lacrimal duct system, but accounts for a low proportion in congenital obstruction of lacrimal duct system. We present a case of congenital dacryocystocele to analyze the clinical features and to explore the clinical treatment effect of special congenital dacryocyst protrusion.
PubMed: 36950401
DOI: 10.12669/pjms.39.2.6819 -
Journal of Pediatric Ophthalmology and... 2021
Topics: Cysts; Eye Abnormalities; Humans; Lacrimal Apparatus Diseases; Lacrimal Duct Obstruction
PubMed: 34039168
DOI: 10.3928/01913913-20210330-01 -
Clinical Ophthalmology (Auckland, N.Z.) 2020Dacryocystocele can be congenital or acquired and acute or chronic, based on underlying pathology. An inferomedial anterior orbital mass lesion can masquerade an...
INTRODUCTION
Dacryocystocele can be congenital or acquired and acute or chronic, based on underlying pathology. An inferomedial anterior orbital mass lesion can masquerade an acquired dacryocystocele with similar symptomatology; however, the treatment varies. Hence, a careful examination of the swelling to differentiate these masquerades is needed to ensure rightful treatment.
PATIENTS AND METHODS
A retrospective, interventional study was performed on consecutive patients from January 2017 to October 2019 who presented with swelling in the lacrimal sac area of varying durations. They underwent computed tomography scans followed by surgical intervention. Their relation to the lacrimal drainage apparatus was explored.
RESULTS
During the study period, 5 such patients were found in the records. The radiology was consistent with anterior orbital mass lesions, not involving the lacrimal sac. Histopathology after surgical excision was consistent with three of the lesions being dermoid cysts, one was cavernous hemangioma and one was a solitary fibrous tumor.
CONCLUSION
Inferomedial anterior orbital mass lesions can present as masquerades of acquired dacrycystoceles. Careful examination and high degree of suspicion is needed to distinguish these lesions and ensure correct treatment.
PubMed: 32753833
DOI: 10.2147/OPTH.S261098 -
Journal of Pediatric Ophthalmology and... May 2023Congenital dacryocystocele presents with a distinct bluish swelling in the medial canthal region in neonates. The authors present four illustrative cases with differing... (Review)
Review
Congenital dacryocystocele presents with a distinct bluish swelling in the medial canthal region in neonates. The authors present four illustrative cases with differing courses and a literature review on dacryocystocele management to raise awareness of the importance of prompt diagnosis, initiation of conservative management, and appropriate referral for surgical assessment. .
Topics: Infant, Newborn; Humans; Lacrimal Duct Obstruction; Cysts; Lacrimal Apparatus; Conservative Treatment
PubMed: 37227990
DOI: 10.3928/01913913-20230320-01 -
Therapeutic Advances in Ophthalmology 2021To determine the demographic and clinical characteristics of newborn patients who underwent lacrimal probing surgical intervention with or without the marsupialization...
PURPOSE
To determine the demographic and clinical characteristics of newborn patients who underwent lacrimal probing surgical intervention with or without the marsupialization of intranasal cysts as the primary management for dacryocystocele treatment.
METHODS
Data from the medical charts of 350 infants who underwent lacrimal probing surgery due to nasolacrimal duct obstruction were reviewed retrospectively. Ten newborn patients with a naive diagnosis of congenital dacryocystocele were included in the study. Congenital dacryocystocele diagnosis was based on a triad of swelling in the inner canthal region, a bluish appearance, and epiphora. Lacrimal probing surgery accompanied by nasal endoscopy was planned for all patients as the first treatment option.
RESULTS
The mean age of the patients was 24.90 ± 7.15 days, with a range of 6-85 days. A total of 10 patients were included, comprising seven females and three males. The mean postoperative follow-up period was 38.7 ± 24.41 months. Five patients had left, four patients had right, and one patient had bilateral dacryocystocele. Seven eyes of the six patients had uncomplicated dacryocystocele, while the remaining patients had dacryocystocele with complications of dacryocystitis and/or preseptal cellulitis. All patients had intranasal cysts. All patients underwent one session of lacrimal probing surgery under general anesthesia; all with successful outcomes. Four patients with additional dacryocystocele-associated complications underwent combined intranasal marsupialization of the cyst wall.
DISCUSSION
Lacrimal probing surgery ± intranasal marsupialization of the cyst wall as a first treatment option can be effective for both congenital dacryocystocele and/or congenital dacryocystocele plus associated complications and provide complete resolution of dacryocystocele-related symptoms.
PubMed: 34291188
DOI: 10.1177/25158414211030427 -
Saudi Journal of Ophthalmology :... 2021Lacrimal sac is situated anterior to the orbital septum, which acts as a barrier, thus limiting the posterior migration of the pathologies affecting the lacrimal...
Lacrimal sac is situated anterior to the orbital septum, which acts as a barrier, thus limiting the posterior migration of the pathologies affecting the lacrimal drainage system. Certain pathologies can breach this barrier and secondarily involve the orbit causing significant clinical manifestations. This posterior migration of pathology also has a significant influence on the management and outcomes. The present paper will discuss the lacrimal pathologies which secondarily involve the orbit and its influence on the management and outcomes.
PubMed: 35601860
DOI: 10.4103/SJOPT.SJOPT_121_21 -
Ophthalmic Plastic and Reconstructive... May 2024Congenital arhinia is a rare anomaly characterized by a syndrome called Bosma arhinia microphthalmia syndrome. A 22-year-old woman with a history of congenital arhinia...
Congenital arhinia is a rare anomaly characterized by a syndrome called Bosma arhinia microphthalmia syndrome. A 22-year-old woman with a history of congenital arhinia presented with bilateral discharge and enlarged bilateral lacrimal sacs, with imaging consistent with bilateral dacryocystoceles and complete absence of nasal structures. This is the first case in the literature that describes surgical management of bilateral dacryocystoceles in a patient with Bosma arhinia microphthalmia syndrome.
PubMed: 38776158
DOI: 10.1097/IOP.0000000000002724 -
International Journal of Surgery Case... Mar 2021Bilateral congenital dacryocystocoele with intranasal extension is very rare and may lead to mild to severe respiratory distress, depending on the degree of obstruction,...
INTRODUCTION AND IMPORTANCE
Bilateral congenital dacryocystocoele with intranasal extension is very rare and may lead to mild to severe respiratory distress, depending on the degree of obstruction, in an otherwise healthy newborn. If severe, an urgent surgical intervention may be life saving. Our aim is to alert paediatric surgeons to this rare condition. Early detection and early treatment with a minimally invasive surgical procedure may be life saving and prevent severe sequelae due to respiratory distress.
CASE PRESENTATION
We present a healthy newborn girl who was admitted to neonatal intensive care with progressive respiratory distress. After a full work-up, she was diagnosed with bilateral dacryocystocoele with intranasal extension and complete obstruction of the anterior nasal cavity. Emergency bilateral endoscopic marsupialization of the cysts with probing of the nasolacrimal duct was performed. The girl recovered without sequelae.
CLINICAL DISCUSSION
In congenital dacryocystocoele, coexistent obstruction of the valve of Rosenmüller and the valve of Hasner is observed. Subsequent intranasal protrusion with obstruction of the inferior nasal cavity may occur. The incidence is unknown, but if bilateral, it is very rare. In most cases, a dacryocystocoele is uncomplicated and may be treated conservatively. However, if intranasal protrusion occurs, and especially if the involvement is bilateral, it is a surgical emergency.
CONCLUSION
Early diagnosis with subsequent minimally invasive surgical treatment of bilateral congenital dacryocystocoele with intranasal protrusion may prevent serious complications due to respiratory distress.
PubMed: 33592409
DOI: 10.1016/j.ijscr.2021.01.097 -
Canadian Journal of Ophthalmology.... Aug 2019To investigate the clinical outcomes of initial conservative management in infants with congenital dacryocystocele.
OBJECTIVE
To investigate the clinical outcomes of initial conservative management in infants with congenital dacryocystocele.
DESIGN
Retrospective case series.
PARTICIPANTS
A total of 30 congenital dacryocystoceles of 28 Korean infants treated between January 2006 and December 2015.
METHODS
All patients were managed conservatively with lacrimal sac massage. Clinical courses and outcomes of the patients were retrospectively reviewed, and rates of resolution of dacryocystoceles and development of dacryocystitis were analyzed.
RESULTS
In 27 cases of dacryocystoceles without infection, spontaneous resolution was achieved without any complication in 20 of 27 (74.1%) cases after conservative treatment. The mean duration of treatment was 27.5 days. Lacrimal probing was needed in 5 (18.5%) dacryocystoceles that persisted despite lacrimal sac massage for more than 1 month. Infectious dacryocystitis developed in 2 of 27 (7.4%) cases. Three dacryocystoceles were infected at presentation. Overall, 5 dacryocystoceles were complicated with infection and those cases received prompt systemic antibiotics treatment. External incision and drainage of the lacrimal sac was needed in 3 dacryocystoceles, and all cases were finally resolved without any additional procedures.
CONCLUSIONS
In this case series, most of the uninfected dacryocystoceles could be successfully managed with conservative treatment alone. In cases with infection, systemic antibiotics were essential and external drainage was sometimes required, but these cases could be conservatively managed after the remission of infection.
Topics: Anti-Bacterial Agents; Conservative Treatment; Cysts; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Lacrimal Apparatus Diseases; Male; Retrospective Studies; Treatment Outcome
PubMed: 31358138
DOI: 10.1016/j.jcjo.2018.08.006