International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 15 , ISSUE 1 ( January-February, 2022 ) > List of Articles


Perplexity and Repercussions in Maldiagnosis of an Extraoral Draining Sinus by a Physician and its Dental Management: A Case Report

Seerat Sidhu, Abi M Thomas, Ruchika Kundra

Keywords : Extraoral cutaneous sinus, Extraoral draining fistula, Nonhealing extraoral sinus, Odontogenic cutaneous fistula, Odontogenic cutaneous sinus tract

Citation Information : Sidhu S, Thomas AM, Kundra R. Perplexity and Repercussions in Maldiagnosis of an Extraoral Draining Sinus by a Physician and its Dental Management: A Case Report. Int J Clin Pediatr Dent 2022; 15 (1):115-118.

DOI: 10.5005/jp-journals-10005-2349

License: CC BY-NC 4.0

Published Online: 13-04-2022

Copyright Statement:  Copyright © 2022; The Author(s).


The cutaneous sinus of dental origin represents a skin disorder that appears due to an infection accompanied by bony changes. The remote location of the lesion relative to the primary site of the disease leads to its presumption of a skin etiology by the individual. Inadequate knowledge on the part of the physician followed by faulty management complicates the situation further. However, unless the dental cause is not addressed, the lesion does not resolve. The following case report discusses the dental management of an extraoral sinus with the aim of guiding the general public, physicians, and dentists with its accurate and timely assessment so as to avoid additional financial costs, futile antibiotic therapy courses, and unnecessary surgical excisions.

  1. Orlow SJ, Watsky KL, Bolognia JL. Skin and bones. II. J Am Acad Dermatol 1991;25(3):447–462. DOI: 10.1016/0190-9622(91)70226-r.
  2. Lewin-Epstein J, Taicher S, Azaz B. Cutaneous sinus tracts of dental origin. Arch Dermatol 1978;114(8):1158–1161. DOI: 10.5694/j.1326-5377.2007.tb00886.x
  3. Ferrera PC, Busino LJ, Snyder HS. Uncommon complications of odontogenic infections. Am J Emerg Med 1996;14(3):317–322. DOI: 10.1016/S0735-6757(96)90186-2.
  4. Stoll HL Jr, Solomon HA. Cutaneous sinuses of dental origin. JAMA 1963;184(2):120–124. DOI: 10.1001/jama.1963.03700150074012.
  5. Uppal A, Thakur S, Chauhan D, et al. Extraoral cutaneous sinus tracts of dental origin: a report of two pedodontic cases. Int Den Med J Adv Res 2017;3:1–4. DOI: 10.15713/ins.idmjar.71
  6. Bast F, Chadha P, Shelly J, et al. Dental sinus infections – Why are we still missing the well documented diagnosis? J Otolaryn Adv 2017;2(1):17–24. DOI 10.14302/issn.2379-8572.joa-17-1602
  7. Slutzky-Goldberg I, Tsesis I, Slutzky H, et al. Odontogenic sinus tracts: a cohort study. Quintessence Int 2009;40(1):13–18. PMID: 19159019.
  8. Sammut S, Malden N, Lopes V. Facial cutaneous sinuses of dental origin – a diagnostic challenge. Br Dent J 2013;215(11):555–558. DOI: 10.1038/sj.bdj.2013.1141.
  9. Alrashdan MS, Darwazeh A, Hossana Y, et al. Awareness of oral medicine among medical practitioners, evidence of the unbridged interdisciplinary gap. J Eval Clin Pract 2019;25(1):142–147. DOI: 10.1111/jep.13029.
  10. Sarumathi T, Saravanakumar B, Datta M, et al. Awareness and knowledge of common oral diseases among primary care physicians. J Clin Diagn Res 2013;7(4):768–771. DOI: 10.7860/JCDR/2013/5419.2908.
  11. Parakh A, Mohapatra AK, Yunus GY, et al. Perception regarding oral health & disease among medical practitioners of durg, Chhattisgarh– a cross sectional study. Chettinad Health City Med J 2016;5(3):120–126.
  12. Gupta R, Hasselgren G. Prevalence of odontogenic sinus tracts in patients referred for endodontic therapy. J Endod 2003;29(12): 798–800. DOI: 10.1097/00004770-200312000-00003.
  13. Chan CP, Jeng JH, Chang SH, et al. Cutaneous sinus tracts of dental origin: clinical review of 37 cases. J Formos Med Assoc 1998;97(9):633–637. PMID: 9795532.
  14. Guevara-Gutiérrez E, Riera-Leal L, Gómez-Martínez M, et al. Odontogenic cutaneous fistulas: clinical and epidemiologic characteristics of 75 cases. Int J Dermatol 2013;54(1):50–55. DOI: 10.1111/ijd.12262.
  15. Chowdri NA, Sheikh S, Gagloo MA, et al. Clinicopathological profile and surgical results of nonhealing sinuses and fistulous tracts of the head and neck region. J Oral Maxillofac Surg 2009;67(11):2332–2336. DOI: 10.1016/j.joms.2008.06.084.
  16. Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent 2010;13(4):256–264. DOI: 10.4103/0972-0707.73378.
  17. Mohammadi Z, Jafarzadeh H, Shalavi S, et al. A review on triple antibiotic paste as a suitable material used in regenerative endodontics. Iran Endod J 2018;13(1):1–6. DOI: 10.22037/iej.v13i1.17941.
  18. Gautam S, Rajkumar B, Landge SP, et al. Antimicrobial efficacy of metapex (Calcium hydroxide with Iodoform formulation) at different concentrations against selected micro-organisms – an in vitro study. Nepal Med Coll J 2011;13(4):297–300. PMID: 23016485.
  19. Kakade A, Juneja A. An unusual association of extraoral sinus tract with unerupted permanent tooth. Pediatr Dent 2013;35(3):284–287. PMID: 23756317.
  20. Ozdemir A, Guven G, Dilsiz A, et al. Diagnosis and treatment of mandibular extraoral sinus of periodontal origin in a 9-year-old boy: a case report. J Indian Soc Pedod Prev Dent 2008;26(Suppl 2):S76–S78. PMID: 19075453.
  21. Kumar KS, Subbiya A, Vivekanandhan P, et al. Management of an endodontic infection with an extra oral sinus tract in a single visit: a case report. J Clin Diagn Res 2013;7(6):1247–1249. DOI: 10.7860/JCDR/2013/5369.3064.
  22. Lodhi K, Nagar AC, Kumar V, et al. Management of periodontal infection leading to mandibular extra-oral sinus in 13-year-old male. SRM J Res Dent Sci 2017;8:140–143. DOI: 10.4103/srmjrds.srmjrds_40_17
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.