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| TEACHING IMAGES |
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| Year : 2014 | Volume
: 2
| Issue : 2 | Page : 261-262 |
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Dacryocystocele
KS Gangadhara Somayaji1, Rajeshwary Aroor2, A Mohammad Nalapad1, K Tom Jones1
1 Department of ENT, Yenepoya Medical College, Nithyananda Nagara, Deralakatte, Karnataka, India
2 Department of ENT, K S Hegde Medical Academy, Mangalore, Karnataka, India
| Date of Web Publication | 11-Nov-2014 |
Correspondence Address:
KS Gangadhara Somayaji
Department of ENT, Yenepoya Medical College, Mangalore, Karnataka
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2321-4848.144368
How to cite this article:
Somayaji KG, Aroor R, Nalapad A M, Jones K T. Dacryocystocele
. Arch Med Health Sci 2014;2:261-2 |
| Case Report | |  |
A 78-year-old lady presented to ENT outpatient with history of watering of left eye since 3 years and painless gradually progressing swelling on the medial aspect of the left eye of 6 months duration [Figure 1]. On examination, the swelling was globular, 2 × 2.5 cm, firm, non-tender, transilluminant and non-compressible situated below and medial to medial canthus on left side extending over the bridge of the nose. Right eye was normal. Syringing revealed a block at the level of common canaliculus. ENT examination was normal. A provisional diagnosis of left dacryocystocele was made. In view of non-fluctuant and firm nature of the swelling, an MRI scan was taken. It was suggestive of a fluid-filled lesion of the left lacrimal sac [Figure 2]. The mass was excised through external incision, and dacryocystectomy was done. The contents of the swelling were mucoid, and the histopathology was consistent with chronic inflammation. | Figure 2: MRI Image showing the swelling involving the left lacrimal sac
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| Discussion | | |
Dacryocystoceles, also called lacrimal mucoceles and amniocelesare secondary to proximal and distal nasolacrimal pathway obstruction resulting lacrimal sac enlargement. [1] Though more commonly seen in infants and young children, occasional cases have been reported in the adults and elderly age group. [2] Extensive mucoceles extending into orbit, intranasally and over the bridge of the nose have been reported. [3] Patients may present with nasal obstruction, watering of the eye, and features of dacryocystitis. Confirmation of the diagnosis is by CT or MRI. [4] When seen in neonates, medical treatment including massage, antibiotic eye drops, and warm compression may be tried. Occasional cases may require probing. [1] However, larger swellings in adults and elderly will require excision through external or endonasal approach depending on the status of common canaliculus. [3]
| References | | |
| 1. | Wasserman BN, Schnall BM, Levin AV. Sequential bilateral dacryocele. Arch Opthalmaol 2011;129:104-5. 
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| 2. | Sagili S, Thaung CM, Malhotra R. Lacrimal sac mucocele. Br J Opthalmol 2013;97:106.
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| 3. | Krisnamurthy G, Padmavar BU, Desai Y. An encysted lacrimal mucocele with orbital extension. Indian J Opthalmol 1977;25:40-1.
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| 4. | Koch BL. Case 73: Nasolacrimal duct mucocele. Radiology 2004;232:370-2.
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[Figure 1], [Figure 2]
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