title: Orbital and Periorbital Extension of Congenital Dacryocystoceles: Suggested Mechanism and Management.
abstract: Orbital and periorbital extension of congenital dacryocystoceles is rarely observed in neonatal infants. The authors describe 4 cases of congenital dacryocystocele that presented with extension to the orbital and periorbital regions. The first 3 newborns underwent marsupialization of the orbital and periorbital dacryocystoceles with aspiration of the purulent material followed by nasolacrimal duct probing after radiographic evidence of diffuse orbital or periorbital expansion. The fourth patient was successfully treated with an external dacryocystorhinostomy with excision of the enlarged cystic walls. Transconjunctival orbitotomy with sac marsupialization followed by nasolacrimal intubation can provide immediate and permanent resolutions of this unusual complication in most instances. External dacryocystorhinostomy may be required, however, when the orbital or periorbital dacryocystocele is complicated by acute or recurrent dacryocystitis.
authors.affiliation: *Department of Ophthalmology, Ospedale Gaslini, Genova, Italy; †Department of Ophthalmology, Dünya Göz Hastanesi, Ankara, Turkey; ‡Department of Neuroradiology, Ospedale Gaslini, Genova, Italy; §Department of Ophthalmology, Istanbul Beyoğlu Eye Research Hospital, Istanbul, Turkey; ‖Division of Pediatric Ophthalmology, The Children's Hospital of Philadelphia; ¶Scheie Eye Institute; and #Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Bernardini
authors.forename: Altug
authors.initials: A
authors.lastname: Cetinkaya
authors.forename: Paolo
authors.initials: P
authors.lastname: Capris
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Pelin
authors.initials: P
authors.lastname: Kaynak
authors.forename: James A
authors.initials: JA
authors.lastname: Katowitz
mesh_terms: D003607:Dacryocystitis / Q000175:diagnosis / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed