Dacryocystocele in the adult: etiology, diagnosis and treatment

Dacryocystocele (DCC) is a pathologic condition frequently found in newborns as a consequence of congenital lacrimal system stenosis. Its occurrence in adult age is an exceedingly rare event and is secondary to inflammation, a neoplasm, facial trauma, or nasal surgery. Diagnosis is based on clinical examination, dacryocystography and computed tomography. Lacrimal system stenoses of the newborns usually recover spontaneously; only 2% to 4% of cases requires a treatment, which includes as a first step probing of the lacrimal system. If the clinical signs and symptoms persist, external or transnasal (endoscopic or microscopic) dacryocystorhinostomy (DCR) is indicated. The present work reports a case of adult DCC treated with endoscopic DCR. Rhinostomy was adequately stabilized and patent 33 months after surgery. The main advantages of the endoscopic compared to the external approach are: preservation of the pumping mechanism of the orbicularis muscle, low incidence of postoperative complications, simultaneous treatment of the nasal lesions, shorter hospitalization time, and absence of facial scars. Furthermore, the success rate for endoscopic DCR is similar to that obtained using an external approach.