Atypical lacrimal sac mucoceles

Area of Science:

• Ophthalmology
• Oculoplastics
• Anatomy

Background:

• Lacrimal sac mucoceles are cystic dilations of the lacrimal sac.
• Extension of mucoceles above the medial canthal tendon (MCT) can mimic other orbital pathologies.
• Understanding the anatomical relationship is crucial for diagnosis and management.

Purpose of the Study:

• To describe the clinical characteristics and surgical findings of lacrimal sac mucoceles extending superiorly to the medial canthal tendon (MCT).
• To evaluate the surgical outcomes for these specific cases.

Main Methods:

• Retrospective chart review of patients with lacrimal sac mucoceles extending above the MCT from 2019-2023.
• Surgical management was performed for all identified patients.
• Data collected included demographics, clinical presentation, imaging, surgical approach, and outcomes.

Main Results:

• 62 patients were analyzed; 67.7% were female, mean age 49.11 years.
• Common symptoms included epiphora, discharge, and dacryocystitis.
• Mucoceles extended above the MCT in 38.7% of cases, causing superior medial canthus displacement; surgical resolution was successful.

Conclusions:

• Lacrimal sac mucoceles can anatomically extend above the medial canthal tendon (MCT).
• While suspicious for neoplastic lesions, superior extension is not pathognomonic.
• Surgical intervention effectively resolves these mucoceles.