Clinic‐Based Transnasal Marsupialization for the Treatment of Congenital Dacryocystocele

OBJECTIVE: To evaluate the feasibility and outcomes of endoscopic intranasal marsupialization as treatment for congenital dacryocystocele, performed under topical anesthesia in a clinical setting. STUDY DESIGN: A retrospective review was conducted at a tertiary pediatric care hospital spanning from 2014 to 2024. SETTING: 23 infants under 1 year of age who underwent marsupialization under topical anesthesia for the treatment of a dacryocystocele were identified and their medical records were analyzed. No control group was used for this study. METHODS: Through a review of patient's medical files, the surgical technique used for cases of marsupialization under topical anesthesia in our medical center was documented and described. RESULTS: The primary outcome was the success rate of marsupialization procedures under topical anesthesia, defined as nonrecurrence. Secondary outcomes comprised periprocedural and postprocedure complications. The age of the patients at diagnosis ranged from 7.1 to 16.4 days. Among the 23 patients, 19 (83%) had previously failed conservative treatment before undergoing surgical intervention. Two patients (9%) experienced recurrent dacryocystocele. There were no perioperative or postoperative complications observed. Following the procedure, the most prevalent persistent symptom was nasal congestion, observed in 4 patients (17%). The mean time to treatment was 4.4 days and the overall hospital duration post-procedure was 0.4 days. CONCLUSION: This study underscores the efficacy and safety of clinic-based endoscopic intranasal marsupialization for treating dacryocystocele. This approach expedites surgical care, eliminates the requirement for general anesthesia and allows a reduced hospital stay, making it a favorable treatment option in clinical practice.