In this case, an extraoral
sinus tract of odontogenic origin was observed.
All patients were treated under general anesthesia with surgical excision of the
sinus tract through a neck incision.
Histopathological examination of
sinus tract under the magnification of 20 showing the presence of granuloma with no central caseation (arrow)
Results showed that there was over prescription of antibiotics for pulpitis,
sinus tract infections and severe gingivitis, which may be treated by clinical therapy alone.
"Once you have
sinus tracts it's critical to remove them."
The primary aim of any surgical approach is the complete excision of the
sinus tract along with potential for rapid healing, lesser morbidity, lesser potential for complications and enhanced long-term results in terms of lower recurrence rates.
Another study examining HS lesions at the time of surgery revealed biofilm formation of
sinus tracts, further suggesting biofilms may play a role in the pathogenesis of HS (23).
Jiang, "Odontogenic cutaneous
sinus tract associated with a mandibular second molar having a rare distolingual root: a case report," Head and Face Medicine, vol.
Fibrous growth in the gingiva exhibits opening of a
sinus tract (arrows) surrounded by an abscess.
The classic histopathology findings included the following: (1) a skin tag: stratified squamous epithelium with occasionally striated muscles or cartilage; (2) a main lesion: stratified squamous epithelium with surface parakeratosis and absence of dermal adnexal structures, with mild inflammatory infiltrate of lymphocytes, plasma cells, and neutrophils possibly present; and (3) a
sinus tract: squamous or pseudostratified columnar epithelium.
Progression of infection may lead to prosthetic loosening, muscle/soft tissue abscess, and eventually the development of a draining
sinus tract [9].
Magnetic resonance imaging performed without contrast demonstrated a 2.2 x 6.5 x 2.1 cm intraosseous abscess contiguous with the
sinus tract communicating with the skin.
