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Published on: October 13, 2017
Clinical presentation and management outcomes of congenital dacryocystocele: a retrospective study
Gülistan Oyur1, Muhammed Mustafa Mazlum1, Fatma Savur1
1Department of Ophthalmology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
Insights
Congenital dacryocystocele in infants often leads to dacryocystitis (infection). Infectious presentation, not perinatal factors, increases the need for surgical intervention in these cases.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Neonatology
Background:
- Congenital dacryocystocele is a common condition in infants.
- Dacryocystitis, an infection of the tear sac, can complicate congenital dacryocystocele.
- Understanding factors associated with dacryocystitis and surgical needs is crucial for optimal infant care.
Purpose of the Study:
- To identify clinical factors linked to dacryocystitis in infants with congenital dacryocystocele.
- To determine predictors for surgical intervention in this population.
- To compare infants with complicated versus uncomplicated congenital dacryocystocele.
Main Methods:
- Retrospective analysis of 26 infants with congenital dacryocystocele.
- Categorization into complicated (with dacryocystitis/cellulitis) and uncomplicated groups.
- Comparison of demographic and perinatal characteristics; analysis of treatment outcomes.
Main Results:
- Over half of infants (53.8%) presented with complicated congenital dacryocystocele.
- No significant differences in demographic or perinatal factors between groups.
- Surgical intervention was required in all complicated cases and 16.7% of uncomplicated cases (p<0.001).
Conclusions:
- Infection-related complications affect approximately half of infants with congenital dacryocystocele.
- Infectious presentation, rather than perinatal factors, correlates with the need for surgery.
- Early detection and management can mitigate risks of dacryocystitis and subsequent surgery.
Purpose:
The purpose of this study was to assess the clinical factors associated with dacryocystitis and the need for surgical intervention in infants with congenital dacryocystocele.
Methods:
This retrospective study included 26 infants diagnosed with congenital dacryocystocele and divided them into two groups: complicated-congenital dacryocystocele (with dacryocystitis or preseptal cellulitis) and uncomplicated-congenital dacryocystocele (without infection). Demographic and perinatal characteristics such as age at diagnosis, gender, birth weight, gestational age, delivery method, and laterality were compared between the groups. For an uncomplicated-congenital dacryocystocele, treatment included conservative management and intravenous antibiotics, followed by probing with intraoperative nasal endoscopy and endonasal marsupialization for a complicated-congenital dacryocystocele.
Results:
Of the 26 infants, 14 (53.8%) had complicated-congenital dacryocystocele, while 12 (46.2%) had uncomplicated-congenital dacryocystocele. There were no significant differences between the groups in terms of demographic or perinatal characteristics (p>0.05). Surgical intervention was necessary for all complicated-congenital dacryocystocele cases (100%) and two uncomplicated-congenital dacryocystocele cases (16.7%; p<0.001). During a 6-month median follow-up period, all patients demonstrated complete clinical recovery with no intraoperative complications.
Conclusion:
In conclusion, approximately half of infants with congenital dacryocystocele developed infection-related complications. While perinatal factors were similar across groups, infectious presentation was linked to the need for surgical intervention. These findings suggest that early detection, prompt conservative management, and close follow-up can help reduce the risk of dacryocystitis and the need for surgery.
