Journal of Surgery. 2014, 2(2), 21-24DOI:
Abstract: A 12-year-old girl presented with a chronically draining lesion on her left cheek. The lesion was refractory to treatment with oral antibiotics. Physical examination revealed a decayed left mandibular first molar, and a panoramic radiograph demonstrated periapical lesion associated with the incriminated teeth. A diagnosis of cutaneous fistula of odontogenic origin was made, and the patient was treated with elective tooth extraction. The cutaneous fistula subsequently resolved. Intraoral examinations and radiographs are critical for making the diagnosis of cutaneous draining sinus tract of odontogenic origin. Many patients undergo unnecessary surgical therapies before having the correct diagnosis made, but root canal therapy or surgical extraction is the treatment of choice. A dental origin must be considered for any chronically draining sinus of the face or neck.