Lacrimal sac diverticulum is a rare condition, and its various symptoms complicate differential diagnosis. We present cases of a peculiar type of lacrimal diverticulum. A 5-year-old girl and a 50-year-old woman presented with a protruding mass inferior to the medial canthus. Each lacrimal system was patent to irrigation. The masses compressed and distorted the lacrimal passage and had no apparent connection with the lacrimal sac in dacryocystography or computed tomography. Surgical exploration and complete excision of the masses were completed. Each patient had an inverted Y- and an inverted V-shaped multilobular cystic mass that was pathologically confirmed as a lacrimal sac diverticulum. Lacrimal sac diverticula may rarely take the form of a multilobular cyst and can present as a lower lid mass. We speculate that an abnormality in lacrimal embryogenesis resulted in multiple blind pouches, a peculiar type of lacrimal sac diverticulum.
Child, Preschool ; Diagnosis, Differential ; Diverticulum/radiography/*surgery ; Eyelids/radiography/surgery ; Female ; Humans ; Lacrimal Apparatus Diseases/radiography/*surgery ; Middle Aged ; Tomography, X-Ray Computed

PURPOSE: We report a simple and effective method of identifying the medial cut end of lower canalicular laceration cases. METHODS: Twenty-seven eyes with lower canalicular lacerations as a result of trauma were involved in the study. Surgery was performed within 48 hours after injury for canalicular reconstruction. Upper canalicular probing was utilized to identify the medial cut end of deep canalicular lacerations when difficulties were encountered. Total time from the initiation of the probing procedure to the identification of the medial cut end of the lower canaliculus was measured. RESULTS: A total of 27 eyes with lower canalicular lacerations were reconstructed. In 20 eyes, the medial lacerated end was located by upper canalicular probing. The mean time from initiation of the probing procedure to identification of the medial cut end of the lacerated canaliculus was 2 minutes. CONCLUSIONS: We conclude that upper canalicular probing in patients with lower canalicular lacerations significantly reduces the time from the initiation of the operation to the identification of the medial cut end of the lower canaliculus.
Adolescent ; Adult ; Aged ; Child ; Diagnostic Techniques, Ophthalmological ; Eye Injuries/*radiography/surgery ; Eyelids/*injuries ; Female ; Humans ; Intubation/methods ; Lacerations/*radiography/surgery ; Lacrimal Apparatus/*injuries/radiography/surgery ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures ; Time Factors