Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
Am J Otolaryngol. 2011 Mar-Apr;32(2):152-5. doi: 10.1016/j.amjoto.2009.11.009. Epub 2010 Jan 8.
The aim of the study was to present a consecutive series of neonatal dacryocele with endonasal cyst diagnosed and treated in our institution and to compare our management regimen and outcome with those reported in the literature.
The study was conducted at a university-affiliated teaching hospital. Study population included 5 infants, ages 1 day to 1 month, with either noninfected or infected neonatal dacryocele with endonasal cyst. Management included antibiotic treatment (topical and/or systemic) and local lacrimal massage. When conservative treatment failed, endoscopic identification and incision of the endonasal cyst with subsequent lacrimal duct irrigation with fluorescein and antibiotics were carried out in the office. Main outcome measures included resolution of symptoms and recurrence rate.
Between the years 2003 and 2007, 5 infants were diagnosed and treated. All had unilateral dacryocele with endonasal cyst. Female-to-male ratio was 4:1. Age ranged from 1 day to 1 month old. Three had dacryocystitis (60%) before treatment. None had symptoms of airway obstruction. One patient was successfully treated conservatively with firm massage by the ophthalmologist resulting in rupture of the endonasal cyst and did not require further treatment. Four patients were treated with a combined ophthalmology/otolaryngology surgical procedure. All patients were treated in an office setting without general anesthesia. One patient underwent computed tomographic imaging before treatment to confirm the diagnosis. Follow-up ranged from 1 month to 50 months with an average of 23 months. Complete resolution was observed in all patients without recurrence and without complications.
We report on the successful surgical treatment of neonatal dacryocele with endonasal cyst in an office setting without the use of general anesthesia, using endoscopic incision of the cyst and irrigation alone. The high success rate of this relatively benign office procedure encourages its use and further supports the approach of early surgical intervention, thus, helping to avoid infectious complications that can be severe at this age.
本研究旨在报告在我院诊断和治疗的连续系列新生儿先天性鼻泪管囊肿，并与文献报道的结果进行比较。
该研究在一家大学附属医院进行。研究对象包括 5 名年龄在 1 天至 1 个月之间的婴儿，均患有非感染性或感染性新生儿先天性鼻泪管囊肿。治疗方案包括抗生素治疗（局部和/或全身）和局部泪囊按摩。当保守治疗失败时，在门诊行内镜下识别和切开鼻内囊肿，随后用荧光素和抗生素冲洗泪道。主要观察指标包括症状缓解和复发率。
2003 年至 2007 年期间，共诊断和治疗了 5 例婴儿。所有患儿均为单侧先天性鼻泪管囊肿。男女比例为 4：1。年龄为 1 天至 1 个月。3 例在治疗前患有泪囊炎（60%）。无患儿出现气道阻塞症状。1 例患儿经眼科医生进行了坚定的按摩，导致鼻内囊肿破裂，无需进一步治疗，成功接受了保守治疗。4 例患儿接受了眼科/耳鼻喉科联合手术治疗。所有患儿均在门诊接受治疗，无需全身麻醉。1 例患儿在治疗前进行了计算机断层扫描以确认诊断。随访时间为 1 个月至 50 个月，平均 23 个月。所有患儿均完全缓解，无复发且无并发症。
我们报告了在门诊环境下，无需全身麻醉，使用内镜下切开囊肿和冲洗的方法，成功治疗新生儿先天性鼻泪管囊肿。这种相对良性的门诊手术成功率高，鼓励使用这种方法，并进一步支持早期手术干预的方法，从而有助于避免在这个年龄段可能发生的严重感染性并发症。
