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Case Reports
. 2009 Nov-Dec;57(6):465-7.
doi: 10.4103/0301-4738.57161.

A rare cause of nasolacrimal duct obstruction: dentigerous cyst in the maxillary sinus

Biswarup Ray  1 , Saumendra Nath Bandyopadhyay, Debabrata Das, Bivas Adhikary
Affiliations
Case Reports

A rare cause of nasolacrimal duct obstruction: dentigerous cyst in the maxillary sinus

Biswarup Ray et al. Indian J Ophthalmol. 2009 Nov-Dec.

Abstract

The most common abnormality of the lacrimal drainage system is congenital or acquired nasolacrimal duct obstruction. The causes of acquired nasolacrimal duct obstruction may be primary or secondary. The secondary acquired obstructions may result from infection, inflammation, neoplasm, trauma or mechanical causes. The maxillary sinus cysts usually obstruct the nasolacrimal duct mechanically. Dentigerous cysts are one of the main types of maxillary cysts. These cysts are benign odontogenic cysts which are associated with the crowns of unerupted teeth. The clinical documentations of mechanical nasolacrimal duct obstructions due to a dentigerous cyst in the maxillary sinus are very rare in literature. In this case report, we describe a dentigerous cyst with a supernumerary tooth in the maxillary sinus in an 11-year-old male child causing an obstruction to the nasolacrimal duct. The case was successfully managed surgically by Caldwell Luc approach.

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Figures

Figure 1
Figure 1
X-ray of the paranasal sinuses showing haziness of the left maxillary antrum with the dental structure near its roof (white arrow)
Figure 2
Figure 2
Axial CT scan of the orbits and sinuses showing the cyst bulging into the nasal cavity and the tooth in the left maxillary antrum (white arrow)
Figure 3
Figure 3
Preoperative left dacryocystogram showing inability of the contrast medium to pass beyond the lacrimal sac (black arrow)
Figure 4
Figure 4
Orthopantogram showing a supernumerary tooth in the left maxillary antrum (black arrow)
Figure 5
Figure 5
The operative specimen of the cyst and the tooth
Figure 6
Figure 6
Postoperative left dacryocystogram showing flow of the contrast medium into the nose (white arrow)
See this image and copyright information in PMC

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