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Updated: Jun 2, 2025

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Endoscopic endonasal dacryocystectomy.

Juhi Daga1, Mohammad Javed Ali1

  • 1Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India.

American Journal of Ophthalmology Case Reports
|January 15, 2025
PubMed
Summary
This summary is machine-generated.

This report details a rare endoscopic endonasal dacryocystectomy (DCT) for a cosmetic indication in a young girl with absent puncta. The technique was adapted due to unique anatomical findings.

Keywords:
DacryocystectomyEndonasalEndoscopicLacrimalPunctal agenesis

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Area of Science:

  • Ophthalmology
  • Otorhinolaryngology
  • Surgical Anatomy

Background:

  • Dacryocystectomy (DCT) is typically performed via an external approach.
  • Endoscopic endonasal DCT is a rare alternative, often used when external wound care is challenging.
  • Congenital dacryocystocele can present with cosmetic concerns and anatomical variations.

Observation:

  • A 14-year-old female presented with bilateral lacrimal sac swelling and absent puncta.
  • Cosmetic concerns and refusal of an external approach led to considering an endoscopic endonasal DCT.
  • The patient exhibited a thin, cystic sac wall and remodeling of the bony lacrimal fossa.

Findings:

  • Successful endoscopic endonasal dacryocystectomy was performed.
  • Surgical steps were modified due to the unique cystic nature of the lacrimal sac and bony fossa remodeling.
  • This case highlights the adaptability of the endoscopic endonasal approach.

Implications:

  • Demonstrates the feasibility of endoscopic endonasal DCT for cosmetic indications in specific pediatric cases.
  • Underscores the importance of adapting surgical techniques based on intraoperative anatomical findings.
  • Expands the armamentarium for treating congenital dacryocystocele when external approaches are unsuitable.