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Published on: October 13, 2017
Process of spontaneous resolution in the conservative management of congenital dacryocystocele
Masashi Mimura1, Mari Ueki2, Hidehiro Oku2
1Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan ; Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan.
Insights
Conservative management, including warm compresses and massage, effectively resolved congenital dacryocystocele in all infant cases. Rupture of the dacryocystocele may precede dacryocystitis, highlighting the importance of careful observation.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital dacryocystocele is a common condition in infants.
- Conservative management is often the first line of treatment.
Purpose of the Study:
- To evaluate the efficacy of conservative management for congenital dacryocystocele.
- To identify potential precursors of dacryocystitis in these patients.
Main Methods:
- Retrospective case series of five infants (six affected sides) with congenital dacryocele.
- Conservative management included warm compresses and massage.
- Antibiotics were administered for dacryocystitis.
Main Results:
- All six dacryocystoceles resolved with conservative management.
- Median age at resolution was 14.5 days.
- Two cases developed dacryocystitis, preceded by retrograde discharge, which resolved with antibiotics.
Conclusions:
- Congenital dacryocystocele has a high resolution rate with conservative management and observation.
- Rupture of the dacryocystocele into the common canaliculus may indicate an increased risk of dacryocystitis.
Purpose:
To assess efficacy of the conservative management of patients with congenital dacryocystocele.
Materials And Methods:
This was a retrospective case series involving six sides of five infants with a dacryocystocele treated at Osaka Kaisei Hospital, Osaka, Japan. The conservative management protocol consisted of the application of warm compresses and massage over the mass, with the addition of antibiotics when dacryocystitis developed. Patient age at the time of resolution, presence of retrograde outflow of contents of dacryocystoceles from the puncta, and development of dacryocystitis were recorded.
Results:
The dacryocystocele was unilateral in four patients and bilateral in one patient. A nasal cyst was present in four patients without respiratory distress. The median patient age at the time of the diagnosis was 7 days (range 2-10 days). Conservative management was selected in all patients, and the dacryocystocele was resolved in all patients at a median patient age of 14.5 days (range 11-105 days). Two sides developed dacryocystitis, which resolved in a few days with antibiotic treatment. In those two sides, rupture of the dacryocystoceles to the common canaliculus with retrograde discharge of the contents from the puncta before the dacryocystitis developed was noted. For the other four treated sides, no such discharge or development of dacryocystitis was observed.
Conclusion:
The findings of this study show that a dacryocystocele has a good chance of resolving spontaneously with conservative management and careful observation, and that rupture of the dacryocystocele to the common canaliculus might be an important precursor of dacryocystitis.
