To evaluate the effect of endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct.

We analyzed 252 patients who were diagnosed with paranasal mucocele from 2006 to 2017, and found 14 patients (14 eyes) who underwent endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct. Clinical features and surgical results of the patients were analyzed retrospectively.

The origins of the mucocele were frontoethmoidal sinus (seven cases, 50%) and ethmoidal sinus(seven cases, 50%). The most common symptom from the first visit was epiphora (13 cases, 92.8%); medial canthal mass (nine cases, 64.2%) was the second most common symptom. Every patient underwent endonasal dacryocystorhinostomy with rhinology and sinus surgery according to the type, size, and severity of the paranasal mucocele. Every patient showed successful irrigation in the lacrimal canalicular irrigation test and improved epiphora 6 months postoperatively.

When paranasal mucocele invades the orbit, it can cause diplopia, exophthalmos, extraocular muscle movement disorders, visual impairments, and increased intraocular pressure. Furthermore, if it invades the nasolacrimal duct, it can cause obstruction of the nasolacrimal duct and result in epiphora. Based on our results, endonasal dacryocystorhinostomy was an effective primary treatment.