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.

Background: A cutaneous sinus tract of dental origin may easily be misdiagnosed. Exact diagnosis is necessary in the management of this pathological situation.

Case description: A healthy 40-year-old man presented with a dimple in the skin of his right cheek. Upon further examination, the clinical crown of the mandibular right first molar was missing, leaving only the roots visible. Palpation of the affected area revealed a cord-like tract that was surgically excised.

Summary: A cutaneous sinus tract of dental origin is a canal that drains the infection from a dental source to the face or neck. A misdiagnosis of these lesions could lead to an ineffective and inappropriate treatment. We report a case of a cutaneous sinus tract of dental origin that we removed from the periapical zone of the causal teeth. The aim of this paper is to present a dental and medical literature review of cutaneous sinus tract that has a dental origin and to report a case where the sinus tract was surgically eliminated. Patients with a cutaneous facial sinus tract of dental origin often do not have obvious dental symptoms that can lead to misdiagnosing this pathological situation.

Clinical significance: Elimination of the source of infection by endodontic treatment or tooth removal generally results in resolution of the sinus tract. But in the case of an older sinus tract, wound contraction and scar tissue formation may require surgical management to excise the cord-like tract.