Roy D, Guevara N, Santini J, Castillo L
Department of ORL, Surgery of the Face and Neck, Hospital Pasteur, Nice, France.
Clin Otolaryngol Allied Sci. 2002 Jun;27(3):167-70. doi: 10.1046/j.1365-2273.2002.00556.x.
A congenital nasolacrimal duct cyst is an uncommon condition in the newborn usually treated by ophthalmologists. Prolapse or expansion of the cyst into the nose may lead to respiratory distress and difficulty in feeding as newborns are obligate nose breathers, which needs the involvement of the Otolaryngologist in diagnosis and management. The authors report a series of 8 children presenting with a congenital nasolacrimal duct cyst and dacryocoele and highlight the importance of endoscopic nasal examination of newborns presenting with respiratory problems. Diagnostic studies included intranasal endoscopy and CT scanning of the nasolacrimal system and nose. All the patients were treated by endoscopic marsupialization of the cyst. Nasolacrimal duct abnormality should be considered in the differential diagnosis of neonatal respiratory distress and nasal obstruction. Nasal endoscopy is essential in the work-up of all children with nasal obstruction and respiratory distress. CT scanning is the investigative method of choice. Endoscopic marsupialization followed by lacrimal duct irrigation is effective in the treatment of congenital nasolacrimal duct cyst and results in complete resolution of symptoms.
先天性鼻泪管囊肿在新生儿中较为罕见，通常由眼科医生进行治疗。由于新生儿是完全靠鼻子呼吸的，囊肿脱垂或扩展至鼻腔可能导致呼吸窘迫和喂养困难，这就需要耳鼻喉科医生参与诊断和管理。作者报告了一系列8例患有先天性鼻泪管囊肿和泪囊膨出的儿童病例，并强调了对出现呼吸问题的新生儿进行鼻内镜检查的重要性。诊断性检查包括鼻内内镜检查以及鼻泪系统和鼻腔的CT扫描。所有患者均接受了囊肿内镜开窗术治疗。在新生儿呼吸窘迫和鼻阻塞的鉴别诊断中应考虑鼻泪管异常。鼻内镜检查对于所有患有鼻阻塞和呼吸窘迫的儿童的检查至关重要。CT扫描是首选的检查方法。内镜开窗术随后进行泪道冲洗对先天性鼻泪管囊肿的治疗有效，并可使症状完全缓解。
