Gigantic Dentigerous Cysts Associated with the Ectopic/Impacted Upper Third Molars: Computed Tomography Analysis of Nasolacrimal Duct and Osteomeatal Complex Obstructions and Review of Literature

Abstract

We report the cases with giant dentigerous cysts (synonym: follicular cysts) of the maxillary sinus which caused ophthalmologic, neurologic, and nasal disturbances. Case 1: A 44-year-old female with osteomeatal complex obstruction and severe headaches due to giant dentigerous cyst associated with impacted upper left wisdom tooth. An air-fluid level and middle turbinate compression with intact lower turbinate became the characteristic features of the case which reviewed in the publications. Case 2: A 60-year-old woman with complete acquired nasolacrimal duct and osteomeatal complex obstruction due to gigantic dentigerous cyst. It’s a first ever reported case when the cyst originated from ectopic upper third molar and led to the permanent left eye epiphora and left side nasal obstruction. In both cases the consecutive pre-operative cone-beam computed tomography is presented and comparison of attenuation coefficient of the cystic content is analyzed.Management of the cases is described, surgical techniques and literature is reviewed; 1-year follow-up period is highlighted.