Abstract
PURPOSE: To report an exceptionally rare instance of Endoscopic endonasal dacryocystectomy. OBSERVATIONS: Dacryocystectomy (DCT), a procedure of surgical extirpation of the lacrimal sac is normally approached by an external route. However, an endoscopic endonasal approach DCT is rare and usually reserved in cases where intellectual disabilities of a patient become a restrictive factor in maintenance of a healthy external wound. The present report describes a 14-years-old girl who presented with bilateral lacrimal sac swelling without epiphora. All the four puncta were absent. She was cosmetically concerned with the swellings and refused an external approach. The sac wall was grossly thin and cystic with remodelling of the bony lacrimal fossa which necessitated change of steps during an endoscopic DCT. CONCLUSION AND IMPORTANCE: The present report describes a cosmetic indication and surgical technique of endoscopic endonasal dacryocystectomy in a young female with bilateral upper and lower punctal agenesis and slowly progressive congenital dacryocystocele without epiphora.