小児前頭篩骨粘液嚢腫による流涙症：SALDOアップデート研究（SUP）-論文VI

To report the presentation, management, and outcomes of paediatric frontoethmoidal mucoceles causing epiphora.

Retrospective, interventional study involving six paediatric patients with paranasal sinus mucoceles presenting with epiphora over 13 years at a tertiary dacryology centre. Demographics, meticulous history, visual acuity, ophthalmic evaluation, lacrimal irrigation, and endoscopic evaluation of the nostril were documented. Computed tomography scans were performed in all patients. All patients underwent an endoscopic endonasal marsupialization of the mucocele. Functional improvements in epiphora and external signs were analysed.

Six paediatric patients with a mean age of 12.83 years and equal sex distribution were included. The main presenting complaint was epiphora in all children and proptosis in one over an average period of 2.4 years. One child had history of trauma. External examination showed a telecanthus in all children and proptosis or dystopia in four. One child with prior trauma had a secondary acquired nasolacrimal duct obstruction (SALDO), while the others had freely patent irrigation. Four patients had ethmoidal and two had fronto-ethmoidal mucoceles, compressing the lacrimal drainage passage. After the endoscopic endonasal marsupialization of the mucocele, five children had relief from the epiphora with reduction in the proptosis and telecanthus. The patient with traumatic SALDO underwent additional endoscopic dacryocystorhinostomy and did well.

Paediatric sinus mucoceles are rare cases with very subtle signs, often presenting first to an ophthalmologist. Thus, vigilance and knowledge about the entity is necessary to identify and manage it in early stages.