J Wound Manag Res.  2020 Oct;16(3):177-181. 10.22467/jwmr.2020.01249.

A Case of Odontogenic Fistula Misdiagnosed as Cutaneous Ulcer on the Alar-Facial Angle

• Kim YS
• Kim BS
• Kim HS
• In SK
• Yi HS
• Kim HI
• Park JH
• Kim HY

• KMID: 2511196
• DOI: http://doi.org/10.22467/jwmr.2020.01249

Abstract

Odontogenic cutaneous fistula of dental origin at the alar-facial groove is rarely reported. As many patients present with only skin lesions without dental problems, it is often confused with a cyst, abscess or pyogenic granuloma. We report the case of a 52-year-old man who presented with a relapsing cutaneous ulcer in the left alar-facial groove area. Ultrasonography findings suggested a ruptured epidermal cyst, and an excisional biopsy was performed. At 10 days after the surgery, wound dehiscence and pus discharge were observed. Computed tomography revealed a sinus tract, and a diagnosis of odontogenic cutaneous fistula was made. After consultation with the dental department, endodontic treatment was performed. During reoperation, a remnant fistula from the left alar-facial groove area to the left upper central incisor was observed, for which fistulectomy was performed. The patient remained disease-free postoperatively. With early accurate diagnosis, patients with odontogenic cutaneous fistula can be protected from unnecessary surgical intervention and ineffective antibiotic therapy.

Keyword

Cutaneous fistula; Oroantral fistula; Epidermal cyst