[Congenital lacrimonasal duct cyst: Do not forget this radiological and clinical entity].
Fiche publication
Date publication
février 2016
Journal
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DEBRY Christian
Tous les auteurs :
Braun JJ, Debry C, Donato L, Riehm S
Lien Pubmed
Résumé
Although obstruction of the lacrimonasal duct is a fairly common finding in newborns, development of a dacryocystocele (nasolacrimal duct cyst) is uncommon and is caused by stenosis in the proximal and distal area of the nasolacrimal duct leading to a cystic dilatation. Its diagnosis remains difficult for the pediatrician, the ENT specialist, the ophthalmologist, and the radiologist. The study of six cases of dacryocystocele and the review of the literature led the authors to describe the clinical and radiological features of this uncommon entity. The symptomatology includes nasal obstruction and, when bilateral, significant respiratory distress in the newborn (obligate nose-breather) and dilatation of the lacrimal duct with blue cystic swelling inferior to the medial canthus or with an inflammatory aspect of the lacrimal duct in case of infection. A careful endoscopic examination of the nasal cavities and CT or MRI imaging reveals a cystic tumor, which arises in the inferior meatus, inferolateral to the inferior turbinate, and can partly or completely obstruct the endonasal space, uni- or bilaterally. CT and MRI are equally sensitive in detecting dacryocystocele and are also useful for differential diagnosis for other cystic or tumoral nasal lesions such as meningoencephalocele, dermoid cyst, and glioma. To avoid the risk of potential complications (respiratory distress or even sudden infant death, infectious ophthalmologic complications), this radiological and clinical entity should not be forgotten. Endoscopic marsupialization leads to immediate and definitive healing recovery.
Mots clés
Cysts, congenital, Female, Humans, Infant, Infant, Newborn, Lacrimal Apparatus Diseases, congenital, Male, Nasolacrimal Duct
Référence
Arch Pediatr. 2016 Feb;23(2):192-6