Discussion Author: Michael J Reiter
Dacrocystocele is a congenital lesion which results in cystic dilatation of the nasolacrimal duct and cystic medial canthal mass. It is the second most common cause of neonatal nasal obstruction (first is choanal atresia). It occurs secondary to imperforate valves of Hasner (at the distal lacrimal duct). Patients present with inner canthal swelling and epiphoria and eventually periorbital cellulitis and dacrocystitis. The majority spontaneously resolve within first 6 months of life. If they persist, treatments include antibiotics and/or probing to relieve obstruction. The radiologic Diff Dx for medial nasoorbital mass includes encephelocele (often associated w/ hydrocephalus), meningocele, dermoid cyst and nasal glioma.
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