30s preview
0:00 / 0:00
Endoscopic Excision of Nasolacrimal Duct Cyst
The patient is a 4 week old female infant with right sided epiphora and complete right sided nasal obstruction resulting in respiratory and feeding difficulty. Physical exam demonstrated a right medial canthal mass consistent with a dacrocystocele. Flexible fiberoptic nasal endoscopy demonstrated an anterior nasal mass below the inferior turbinate occluding the entire right nasal cavity consistent with a nasolacrimal cyst. The etiology is obstruction at the level of Hassner’s valve.
1. Lidocaine with epinephrine pledgelets are placed in the nasal cavity around the nasal mass and inferior turbinate 2. Nasolacrimal duct probing is performed by a pediatric ophthalmologist 3. Marsupialization is performed under endoscopic visualization by a pediatric inferior turbinate microdebridder. Special care is taken to not demucosalize the inferior turbinate and lateral nasal wall. 4. The nasolacrimal system is irrigated to clear any debris from the system.
Infants with nasal obstruction secondary to a nasolacrimal duct cyst. Unilateral cases present with unilateral nasal obstruction and rhinorrhea. Bilateral cases present with severe respiratory distress requiring prompt intervention.
Any contradiction to general anesthesia
Pediatric sinus telescope (0 and 30 degree), karl storz camera and monitor, pediatric inferior turbinate microdebridder
CT Scan of the sinus
Mass is located anterior and inferior to the middle turbinate. (Be careful not to demucosalize the undersurface of the inferior turbinate and lateral nasal wall. This can lead to synechiae formation and nasal stenosis)
Advantages: Improved nasal airway and breathing Disadvantages: Risk of general anesthesia
1. Synechiae and nasal stenosis if there is demucosalization of the undersurface of the inferior turbinate and lateral nasal wall. 2. Recurrent nasolacrimal duct cyst.
Not Available
Not Available
N/A
Related Videos
A Global Presence
for Surgical Education
Little Rock, AR
© 2026 CSurgeries.com
Are you watching this video for CME credit?
This is approved for 0.5 AMA PRA Category 1 Credit™ via CineMed (ACCME / ACPE / ANCC). The two viewing modes are different — pick what fits your time.
Watch for CME
CME mode (ACCME-compliant):- Full video — no skipping
- Question set unlocks at end
- 0.5 credit + certificate
- ~11 min total (8 video + 3 Q)
Watch casually
Free playback:- Skip / fast-forward enabled
- No questions, no credit
- Reload to switch later
CME Feedback
You have gained maximum
CME credits this year.
Your CME credits will reset next year. You can still continue to watch our videos.
Newsletter Signup
"*" indicates required fields
Review Endoscopic Excision of Nasolacrimal Duct Cyst.