Nasolacrimal duct obstruction in dacryocystocele with large nasolacrimal duct cysts causing acute respiratory distress

Clinical scenario

Dacryocystocele with large nasolacrimal duct cysts can cause acute respiratory distress in neonates through complete occlusion of the nares. Because newborns are obligate nasal breathers, complete nasal occlusion by a large NLD cyst constitutes a time-sensitive emergency.

Specific situation

Large nasolacrimal duct cysts may cause respiratory problems in newborns. The severity ranges from acute respiratory distress due to complete occlusion of the nares to intermittent feeding difficulties caused by NLD cysts that obstruct the airway and become symptomatic when the infant's mouth is covered during feeding.

Approach

The emergent scenario — acute respiratory distress from complete nasal occlusion — requires an urgent procedural intervention to restore the airway.

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References

First, if the nasolacrimal duct cysts are large, they may cause respiratory problems in newborns.

This can range from acute respiratory distress due to complete occlusion of the nares (which requires emergent endoscopy and cyst removal), to intermittent feeding difficulties (caused by NLD cysts that obstruct the airway and become symptomatic when the infant's mouth is covered during feeding).

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