Muhammad Harith Mohamed Rouse1¹ ², Azliana Aziz¹, Nor Shahida Abd Mutalib², Nurliza Idris².

Congenital bilateral dacryocystocele with concomitant congenital nasal pyriform aperture stenosis is a very rare case we see in infants or newborn. We report a case referred by the paediatric department to rule out choanal stenosis. The referring department had difficulty inserting a feeding tube to the patient. Otherwise, the patient does not have nasal or eye discharge. Nose and throat examination showed reduced misting on cold spatula test and inability to introduce nasal endoscope into both nostrils, which indicates obstruction. Computed tomography and magnetic resonance imaging revealed congenital dacryocystocele with nasal pyriform aperture stenosis. The patient was managed surgically by marsupialization of dacryocystocele and drilling of the stenotic part with good recovery. 

Keywords: Congenital dacryocystocele, nasal pyriform aperture stenosis, congenital anomalies, choanal stenosis.

1 Department of Otorhinolaryngology – Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia.

2 Department of Otorhinolaryngology – Head & Neck Surgery, Hospital Sultan Abdul Halim, Sungai Petani, Kedah, Malaysia.

Correspondence to: 

Dr Muhammad Harith bin Mohamed Rouse

Department of Otorhinolaryngology-Head & Neck Surgery, 

School of Medical Sciences, Universiti Sains Malaysia Health Campus, 

16150 Kota Bharu, Kelantan, Malaysia

E-mail: [email protected]