Natesh B G, Patil S, Nilssen E, Maclean H
Queen Alexandra Hospital, Portsmouth, UK.
Royal Surrey County Hospital, Guilford, UK.
Indian J Otolaryngol Head Neck Surg. 2016 Mar;68(1):115-7. doi: 10.1007/s12070-015-0948-y. Epub 2015 Dec 19.
Congenital intranasal nasolacrimal duct (NLD) cyst is a rare clinical entity in the newborn whilst inferior mucocoeles are more common. We reviewed our case series of the management of patients presenting with congenital intranasal NLD cysts and inferior mucocoeles treated using powered instrumentation under endoscopic guidance.
A retrospective review identified three patients, between 2010 and 2013, who have had microdebrider assisted endoscopic marsupialisation of congenital intranasal NLD cysts under joint ENT and Ophthalmology care.
Diagnosis was made based on intraoperative endoscopic nasal examination carried out during treatment of patients with epiphora. All patients were 2 years old or younger presented with persistent epiphora since birth with sticky eyes. All had normal development with no other past medical history of note. Two patients had unilateral and one patient had bilateral congenital intranasal NLD cysts/inferior mucocoels identified. These were treated by endoscopic incision of the cyst with drainage of pus and excision of excess mucosal tissue using a powered microdebrider to effect marsupialisation and prevent re healing of the floppy redundant flaps of the incised cyst. No silastic tubes were placed. All patients were discharged from clinic 3 months post surgery with complete resolution of symptoms and no complications.
Microdebrider assisted endoscopic marsupialisation is a safe and effective treatment for removal of excess tissue in the treatment for congenital intranasal NLD cyst/inferior mucocoele whilst also obviating the need for silastic intubation and a further general anaesthetic for stent removal.
先天性鼻内鼻泪管（NLD）囊肿在新生儿中是一种罕见的临床病症，而鼻下黏液囊肿则更为常见。我们回顾了一系列使用电动器械在鼻内镜引导下治疗先天性鼻内NLD囊肿和鼻下黏液囊肿患者的病例。
一项回顾性研究确定了2010年至2013年间的三名患者，他们在耳鼻喉科和眼科联合治疗下接受了微型切割器辅助的鼻内镜下先天性鼻内NLD囊肿造袋术。
诊断基于在治疗溢泪患者时进行的术中鼻内镜检查。所有患者均为2岁及以下，自出生以来一直有持续性溢泪且眼睛有黏性分泌物。所有患者发育正常，无其他值得注意的既往病史。两名患者为单侧，一名患者为双侧先天性鼻内NLD囊肿/鼻下黏液囊肿。通过鼻内镜切开囊肿，引流脓液，并使用电动微型切割器切除多余的黏膜组织，以实现造袋术并防止切开囊肿的松弛多余皮瓣重新愈合。未放置硅胶管。所有患者术后3个月出院，症状完全缓解，无并发症。
微型切割器辅助的鼻内镜下造袋术是治疗先天性鼻内NLD囊肿/鼻下黏液囊肿时切除多余组织的一种安全有效的方法，同时也无需进行硅胶插管以及为取出支架再次进行全身麻醉。
