Nasolacrimal duct mucocele

Last revised by Henry Knipe on 1 Jun 2020

Nasolacrimal duct mucocele represents cystic dilatation of the nasolacrimal apparatus secondary to proximal +/- distal obstruction of the nasolacrimal duct.

The presentation is common early in infancy, typically 4 days to 10 weeks. Infants present with small round bluish medial canthus mass identified at birth or shortly after +/- distal intra-nasal cystic lesion causing nasal obstruction. Symptoms may include:

Tears and mucus accumulate in the nasolacrimal duct with the imperforate Hasner membrane (distal duct obstruction) 1.

 The following triad of imaging findings 2:

  • medial canthus mass that represents an enlarged lacrimal sac in contiguity with enlarged nasolacrimal duct
  • enlarged osseous nasolacrimal canal secondary to an enlarged soft tissue nasolacrimal duct
  • intranasal cystic mass which represents the inferior extension of the mucocele

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