Otoscopy-Assisted Intranasal Cyst Marsupialization for Congenital Dacryocystocele

Abstract Purpose We report a novel, simple intranasal cyst marsupialization (ICM) technique for congenital dacryocystocele (CDC). Design: Prospective observational study Methods Twenty consecutive infants with 25 CDCs treated at our facility from 2011 to July 2023 were enrolled. Five infants with five CDCs required surgical interventions due to resistance to conservative treatment. Among these five infants, we evaluated the surgical method and the outcomes in three infants with three CDCs who underwent otoscopy-assisted ICM. Results Of the total 25 CDCs, 20 (80%) spontaneously resolved with conservative treatment. Surgical intervention was conducted on five consecutive infants with five CDCs. The mean age at surgery was 100.8 (standard deviation [ SD ] = 77.6) postnatal days. The surgical procedures involved one of the following methods: (1) Probing by an ophthalmologist (2 CDCs); (2) Otoscopy-guided ICM performed by an otolaryngologist in the manner of otoscopic myringotomy (3 CDCs). All infants were treated successfully by a single surgical procedure under topical anesthesia in an office setting. Conclusion CDC was successfully treated by ICM in the manner of an otoscopic myringotomy. Treatment of CDC using an otoscope and myringotome is a minimally invasive surgical procedure that can be performed in an office setting without the need for general anesthesia or advanced medical equipment such as a nasal endoscope. Moreover, the risk of false passage formation and/or recurrence after probing can be avoided. Therefore, we propose this procedure as one of the practical ICM techniques for CDC.