Surgical treatment of congenital nasolacrimal duct cyst with intranasal extension at the Hospital Regional de Talca. A case series

Abstract

Introduction: Congenital duct cyst is a rare pathology of the lacrimal duct. When it extends as an intranasal duct cyst, it can cause airway obstruction and respiratory difficulty. Aim: to present the experience of Hospital Regional de Talca, in the endoscopic surgical treatment of intranasal duct cysts that are complicated or do not respond to conservative treatment. Materials and Methods: Retrospective descriptive study of patients operated between July 2018-August 2024. The surgery consisted of lacrimal probing, marsupialization and remo­val of the cyst through a nasal endoscopic approach. Results: The diagnosis of intranasal duct cyst was confirmed in 10 patients (mean age 31.3 days). The main presentation was a referral for dacryocystitis (8/10). The sample has characteristics similar to those reported internationally: it affects both sexes, with the female sex predominating (8/10), it presents as a unilateral cystic lesion, but up to 40% presents bilaterally. The surgery was successful in 100% of the cases, which was evidenced by making the tear duct permeable with saline irrigation. The prognosis is good, and to date no patient has presented complications or new surgical intervention. Conclusion: When an intranasal duct cyst is suspected, joint intervention by an ophthalmologist and an otolaryngologist is preferred. Nasal endoscopy is important in diagnosis and better management of this pathology, especially when there is bad response to conservative treatment, respiratory symptoms or dacryocystitis. The treat­ment in these cases is surgical, for endoscopic marsupialization of intranasal mucocele and probing of the tear duct.