Presentation and Management of Congenital Dacryocystocele

Abstract

OBJECTIVE. Our goal was to report the presentation, complications, and treatment strategies for infants with congenital dacryocystocele. PATIENTS AND METHODS. We performed a retrospective chart review of all patients presenting with dacryocystoceles to Children's Hospital Boston between the years of 1997 and 2006. This study was approved by the institutional review board. RESULTS. Forty-two patients (46 eyes) were identified (18 male, 24 female), presenting at a median age of 7 days of life. Twenty-eight (65%) patients presented with cellulitis or dacryocystitis and required systemic antibiotics. Four (9.5%) patients presented with respiratory compromise. Resolution occurred with conservative treatment for 10 eyes, but 36 (78%) required surgical intervention. Seventeen (37%) eyes received probing in the office or nursery, and 13 (76%) were successful. Probing in the operating room was required for 21 patients, 8 of whom required marsupialization of an intranasal cyst. CONCLUSIONS. Although congenital dacryocystoceles may resolve with conservative measures, many become infected and require systemic antibiotic treatment, and most require surgical intervention. Referral in the early neonatal period can aid in timely intervention before complications such as infection occur.