Surgical Management of a Cutaneous Sinus Tract: A Case Report and Review of the Literature

Abstract

Aim: The purpose of this paper is to present a case involving the surgical management of a cutaneous sinus tract and a literature review.

Esthetic improvement of a cutaneous sinus tract of odontogenic origin

“…Like our patient, affected patients usually search help from surgeons or dermatologists rather than dentists and often undergo multiple inappropriate treatments. Furthermore, a dental origin can present a diagnostic challenge because these tracts often have a clinical appearance similar to other uncommon facial lesions [ 5 , 6 ] The correct diagnoses allow prompt resolution of the lesion, while misdiagnoses can delay treatment and lead to facial deformity [ 7 ]. The pathophysiology of facial lesions of dental origin is well described in the literature.…”

Esthetic improvement of a nasolabial cutaneous sinus tract

“…Furthermore, this lesion can present a diagnostic challenge because these tracts often have a clinical appearance similar to other uncommon facial lesions. [ 10 11 ]…”

“…Histologically, the cutaneous sinus usually consists of granulomatous tissue or epithelium. [ 11 23 ] Diagnostic errors can result in multiple surgical excisions and biopsies, antibiotic therapy, and even radiation therapy. [ 21 ]…”

“…Rare entities to be included in the differential diagnosis are developmental defects of thyroglossal duct origin or branchial cleft, salivary gland and duct fistula, dacryocystitis, and suppurative lymphadenitis. [ 11 24 ]…”

Facial fistula

“… 2 , 3 However, contaminated roots are considered a source of infection and commonly exacerbated to develop extraoral cutaneous fistula. 4 These cutaneous lesions often present diagnostic challenges as the lesion may arise not in close proximity to the source of the infection, and therefore misdiagnosed and treated inappropriately. 5 - 7 Our objective is to report a case of facial fistula that developed 8 years following a dental extraction, and to emphasize the importance of a thorough clinical examination prior to any treatment.…”