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Canaliculocoele: A Case Series and Review of Literature
Nisar Sonam Poonam1, Avriel Isaac Gudkar1, Md Shahid Alam2
1Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India.
Insights
This case series highlights canaliculocoele, a rare lacrimal sac condition affecting middle-aged women. Early diagnosis through clinical evaluation, imaging, and histopathology is crucial for effective management.
Area of Science:
- Ophthalmology
- Oculoplastics
- Lacrimal System Disorders
Background:
- Canaliculocoele is a rare cystic dilation of the lacrimal canaliculus.
- It often presents as a unilateral medial cystic swelling in the eyelid.
- Accurate diagnosis can be challenging, requiring a combination of clinical and imaging findings.
Purpose of the Study:
- To present a case series of canaliculocoele.
- To review the existing literature on this condition.
- To emphasize diagnostic and management strategies.
Main Methods:
- Retrospective analysis of five histopathologically confirmed cases of canaliculocoele.
- Inclusion criteria: diagnosis between January 2018-December 2019, minimum 6-week follow-up.
- Diagnostic tools included clinical examination, ultrasound biomicroscopy, and histopathology.
Main Results:
- Five cases of canaliculocoele were identified over two years.
- Mean age was 58.8 years, with a female predominance.
- Common findings included medial cystic swelling, punctal stenosis or absence, and canalicular cystic distension on ultrasound biomicroscopy.
- Surgical management involved cystectomy or marsupialization, with some cases receiving mini-Monoka intubation.
Conclusions:
- Canaliculocoele predominantly affects middle-aged women and is typically unilateral.
- A comprehensive approach combining clinical assessment, imaging (ultrasound biomicroscopy), and histopathology is essential for diagnosis.
- Surgical intervention is the mainstay of treatment.
Aim:
To report a case series on canaliculocoele and to review the existing literature.
Methods And Materials:
A retrospective analysis of the case records of all patients diagnosed with canaliculocoele between January 1st, 2018, and December 31st, 2019, was conducted. Only histopathologically proven cases of canaliculocoele with a minimum follow-up of 6 weeks were included.
Results:
Five cases of canaliculocoele that presented over 2 years were included. The mean age was 58.8 ± 9.63 years, with a female preponderance. The mean duration of symptoms was 22.2 ± 22.71 months. All patients had medial cystic swelling, either at the upper or lower lid. Four patients had gross stenosis of the punctum, while the punctum was absent in one patient. Ultrasound biomicroscopy showed canalicular cystic distension with intra-lesional hyper-reflective echoes. All patients were managed with a complete cystectomy, except for one where a marsupialization was done. Adjunctive mini-Monoka intubation was done in two patients. The histopathological diagnosis of all cases was consistent with canaliculocoele. The mean follow-up was 3.82 ± 2.77 months.
Conclusion:
Canaliculocoele is mostly unilateral and seen in middle-aged women. A good clinical evaluation supported by diagnostic imaging along with an affirmative histopathology can confirm the diagnosis.
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