Nasolacrimal duct mucocele
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Nasolacrimal duct mucocele represents cystic dilatation of the nasolacrimal apparatus secondary to proximal +/- distal obstruction of the nasolacrimal duct.
Clinical presentation
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:
- tearing or crusting at the medial canthus
- preseptal cellulitis
Pathology
Tears and mucus accumulate in nasolacrimal duct with imperforate Hasner membrane (distal duct obstruction) 1.
Radiographic features
The following triad of imaging findings 2:
- a medial canthus mass that represents an enlarged lacrimal sac in contiguity with enlarged nasolacrimal duct
- an enlarged osseous nasolacrimal canal secondary to an enlarged soft tissue nasolacrimal duct
- an intranasal cystic mass which represents the inferior extension of the mucocele
Differential diagnosis
- medial canthus cyst: acquired dacryocystocele, orbital dermoid and epidermoid cysts
- intranasal cyst: nasal glioma, hemangioma and cephalocele
-<p><strong>Nasolacrimal duct mucocele</strong> represents cystic dilatation of the <a title="Nasolacrimal apparatus" href="/articles/nasolacrimal-drainage-apparatus">nasolacrimal apparatus</a> secondary to proximal +/- distal obstruction of the <a title="Nasolacrimal duct" href="/articles/nasolacrimal-duct">nasolacrimal duct</a>.</p><h4>Clinical presentation</h4><p>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:</p><ul>- +<p><strong>Nasolacrimal duct mucocele</strong> represents cystic dilatation of the <a href="/articles/nasolacrimal-drainage-apparatus">nasolacrimal apparatus</a> secondary to proximal +/- distal obstruction of the <a href="/articles/nasolacrimal-duct">nasolacrimal duct</a>.</p><h4>Clinical presentation</h4><p>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:</p><ul>
-<li><a title="Preseptal cellulitis" href="/articles/orbital-infection">preseptal cellulitis</a></li>- +<li><a href="/articles/orbital-infection">preseptal cellulitis</a></li>
-<a href="/articles/medial-canthus-cyst">medial canthus cyst</a>: acquired dacryocystocele, <a title="Orbital dermoid cyst" href="/articles/orbital-dermoid-cyst">orbital dermoid</a> and epidermoid cysts</li>- +<a href="/articles/medial-canthus-cyst">medial canthus cyst</a>: acquired dacryocystocele, <a href="/articles/orbital-dermoid-cyst">orbital dermoid</a> and epidermoid cysts</li>
Images Changes:
Image 1 MRI (T2) ( create )
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