Usefulness of high-frequency ultrasonography in the diagnosis of odontogenic cutaneous fistula

Altemir, Arcadi; Iglesias‐Sancho, Maribel; Quintana-Codina, Monica

doi:10.1016/j.abd.2020.06.013

Cited by 3 publications

(6 citation statements)

References 5 publications

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“…17 The chin (30%) and the angle of the jaw (40%) are the most common sites of drainage. 19,20 These data are concordant with our results, in 10 (62.5%) of 16 cases the locations of the cutaneous lesion were chin, submental region or other sites of the mandibular region. Even though in most cases the location of the skin lesion is relatively contiguous to the affected tooth, sometimes it may be distant, sinus tract could reach even the cervical region.…”

Section: Discussionsupporting

confidence: 91%

“…Finally, HR‐US allows monitoring the response to treatment by documenting a decrease in vascularization and a progressive reduction of the sinus tract. This technique may also be useful in the detection of early recurrences 20,42 . Potential complications of untreated OCSTs include contiguous spread of infection to adjacent teeth and bone to form satellite cysts, mandibular osteomyelitis, maxillary sinusitis, orbital abscess, and septicemia 8 …”

Section: Discussionmentioning

confidence: 99%

“…This technique may also be useful in the detection of early recurrences. 20,42 Potential complications of untreated OCSTs include contiguous spread of infection to adjacent teeth and bone to form satellite cysts, mandibular osteomyelitis, maxillary sinusitis, orbital abscess, and septicemia. 8 Since OCSTs are often misdiagnosed as skin lesion without endodontic origin, a detailed clinical history and comprehensive dental examination are crucial to differentiate them from osteomyelitis, actinomycosis, foreign body reaction, local skin infection, pyogenic granuloma disorder, epidermoid or thyroglossal cysts, salivary gland, and duct fistula, suppurative lymphadenitis and basal or squamous cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

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High‐Resolution Ultrasound of Odontogenic Cutaneous Sinus Tract

Corvino,

Catalano,

Wortsman

et al. 2024

J of Ultrasound Medicine

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ObjectivesTo investigate the role of high‐resolution ultrasound (HR‐US) in the initial and differential diagnosis of the Odontogenic Cutaneous Sinus Tract (OCST) in a multicentric setting.MethodsSkin HR‐US examinations of OCSTs performed between January 2019 and June 2023 at different Institutions were retrospectively reviewed. Epidemiological and clinical data (age, gender, location of the skin lesion, causative tooth, and the clinical suspicion) as well as HR‐US imaging findings (morphology and length of the sinus tract, Doppler signal, and cortical bone interruption of maxilla or mandible) were collected. US examinations were performed by expert radiologists using a high‐performance US scanner, employing a high‐frequency linear probe (15 MHz or higher frequencies). In only one patient the HR‐US exam was integrated with strain elastography (SE).ResultsSixteen patients were enrolled with a median age of 37.6 years (range 16–70 years). The most frequent clinical suspicion was epidermal cyst, while OCST was suspected in only two cases. In all cases, HR‐US depicted the sinus tract as a nodular, triangular or “champignon‐shaped” lesion in the subcutaneous layer, which continued with a slightly tortuous band structure, up to the focally interrupted cortical bone plate. Furthermore, color Doppler evaluation showed color signals around and/or within the lesion, expression of inflammation. On SE, the sinus tract showed a hard pattern, due to fibrous and granulomatous tissue.ConclusionsHR‐US, thanks to its high spatial resolution, allows the evaluation of OCST, and play a crucial diagnostic role, mainly when the clinical suspicious is different.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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High‐Resolution Ultrasound of Odontogenic Cutaneous Sinus Tract

Corvino,

Catalano,

Wortsman

et al. 2024

J of Ultrasound Medicine

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“…Cone-beam CT can be used to reveal the 3D extent of apical infection. 11,14 Surgical extraction of the fistula in combination with root canal treatment or dental extraction of the affected tooth is the treatment of choice and is curative in most cases. The Fistula tract may be identified by raising an intraoral full-thickness mucoperiosteal flap, dissecting around the tract in process.…”

Section: Discussionmentioning

confidence: 99%

“…Imaging tests commonly used include periapical x-ray, panoramic radiograph, or cone-beam CT. Periapical x-ray and orthopantomograph often show radiolucency at the apex of the affected tooth. Cone-beam CT can be used to reveal the 3D extent of apical infection 11,14 …”

Section: Discussionmentioning

confidence: 99%

Odontogenic Cutaneous Fistula: A Zombie Diagnosis

Taylor,

Mirsky,

Jabori

et al. 2024

Journal of Craniofacial Surgery

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Background: Odontogenic cutaneous fistula (OCF) is a pathologic communication between the cutaneous surface of the face and oral cavity. Majority of oral cutaneous fistulas are reported to arise from chronic dental infection. Delay in treatment may result in chronic tissue injury as well as cosmetic deformities. Lesions are often misdiagnosed, leading to delayed management. Misdiagnosis may be the result of the variability of clinical morphological presentation and location of lesions compounded by the lack of knowledge that these lesions can have dental etiology. It is estimated that half of patients with OCF undergo multiple dermatologic surgical operations, antibiotic regimens, and other excisions and biopsies before a correct diagnosis is made. Herein, we present a systematic review to detail cases of odontogenic cutaneous lesions that had been previously misdiagnosed or managed inappropriately. In addition, we include a case report from our own institution. The aims are to demonstrate various presentations of OCF, increase awareness of plastic surgeons and oral maxillofacial surgeons to this pathological condition, and reinforce the importance of prompt diagnosis and treatment. Methods: The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in PubMed, Web of Science, and Cochrane databases from January 1, 2013 to July 24, 2023. The following search terms were utilized: “odontogenic cutaneous fistula” OR “odontogenic cutaneous sinus.” Results: Twenty-three articles published between 2013 and 2023 were included in this review. In addition, we report a case from our own institution. A total of 28 cases were included in the review. Conclusions: Diagnosis of OCF is challenging for numerous reasons. Misdiagnosis can lead to multiple trials of antibiotics and surgical procedures as well as reoccurrence of the lesion. Cases summarized highlight the importance of communication between oral maxillofacial surgery, plastic surgery, other medical subspecialists, and dentists in the evaluation of patients with head and neck lesions. Physicians should consider dental etiology in the differential diagnosis of orofacial skin lesions, even if teeth appear normal on oral examination.

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