Prevalence and clinical characteristics of congenital dacryocystocele.

OBJECTIVE: To report the prevalence, clinical findings, and outcomes in children diagnosed with congenital dacryocystocele in a well-defined population during a 20-year period.

METHODS: The medical records of all Olmsted County, Minnesota, patients diagnosed with congenital dacryocystocele from January 1, 1988, through December 31, 2007, were retrospectively reviewed.

RESULTS: A total of 9 children were diagnosed with dacryocystocele during the 20-year period, yielding a birth prevalence of 1 in 3,884 live births. The median age at diagnosis was 12 days (range, birth to 40 days); 7 (78%) were female. Eight patients (89%) had unilateral disease. Clinical findings included a cystic mass in all 9, dacryocystitis in 3 (33%), intranasal cysts in 3 (33%), and 1 (11%) each with facial cellulitis and dacryocystocele-induced astigmatism. Conservative treatment resolved the obstruction in 3 (33%), whereas the remaining 6 (67%) each underwent one surgery. Complete resolution was observed in all 9 patients.

CONCLUSIONS: Congenital dacryocystocele is an uncommon unilateral condition of predominantly neonatal females. Clinical findings support a relatively high incidence of complications such as dacryocystitis and intranasal cysts as well as a less common finding of astigmatism that resolved without evidence of amblyopia. One-third of the cases were successfully managed with conservative treatment alone; most patients required surgical intervention.