ABSTRACT
Background:
Proboscis lateralis (PL) is a rare
congenital malformation of the craniofacial structure. On the basis of 34 reported cases, Boo-Chai developed the first
classification system in 1985 based on commonly associated anomalies of the
eyes,
palate, and
lips. Sinonasal
deformity is the most prevalent systemic abnormality associated with PL,
accounting for 87.9%, and concomitant ocular anomalies account for 44-70%. Case Description We
report a case of PL in a 20-month-old
female patient with a mass in the left medial canthal area, and ipsilateral symptomatic
epiphora. The removal of the proboscis at 4 months without the reconstruction of the
nasolacrimal duct resulted in
secondary sequelae that lasted 16 months. A second operation by a multidisciplinary team released the
pressure on the
lacrimal sac and reconstructed the lacrimal system. External
dacryocystorhinostomy (DCR) is performed through the original external incision aided by nasal endoscopic examination. The bony passage between the
nasal cavity and the
lacrimal sac was reconstructed, and nasal
endoscopy revealed a wide opening in the
nasal cavity of at least 6 mm. Follow ups ensured a patent nasal
airway, without
complications.
Conclusions:
It is instructive to learn from this case that
treatment plans for PL should consider associated ocular anomalies and lacrimal
drainage reconstruction, following a comprehensive and multidisciplinary approach.
