title: Process of spontaneous resolution in the conservative management of congenital dacryocystocele.
abstract: OBJECTIVE
  To assess efficacy of the conservative management of patients with congenital dacryocystocele.
  
  
  METHODS
  This was a retrospective case series involving six sides of five infants with a dacryocystocele treated at Osaka Kaisei Hospital, Osaka, Japan. The conservative management protocol consisted of the application of warm compresses and massage over the mass, with the addition of antibiotics when dacryocystitis developed. Patient age at the time of resolution, presence of retrograde outflow of contents of dacryocystoceles from the puncta, and development of dacryocystitis were recorded.
  
  
  RESULTS
  The dacryocystocele was unilateral in four patients and bilateral in one patient. A nasal cyst was present in four patients without respiratory distress. The median patient age at the time of the diagnosis was 7 days (range 2-10 days). Conservative management was selected in all patients, and the dacryocystocele was resolved in all patients at a median patient age of 14.5 days (range 11-105 days). Two sides developed dacryocystitis, which resolved in a few days with antibiotic treatment. In those two sides, rupture of the dacryocystoceles to the common canaliculus with retrograde discharge of the contents from the puncta before the dacryocystitis developed was noted. For the other four treated sides, no such discharge or development of dacryocystitis was observed.
  
  
  CONCLUSIONS
  The findings of this study show that a dacryocystocele has a good chance of resolving spontaneously with conservative management and careful observation, and that rupture of the dacryocystocele to the common canaliculus might be an important precursor of dacryocystitis.
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan ; Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mimura
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Ueki
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Oku
authors.affiliation: Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan.
authors.forename: Bunpei
authors.initials: B
authors.lastname: Sato
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Ikeda
keywords: congenital lacrimal obstruction; dacryocystitis; precursor; remnant; retrograde discharge