• The Journal of the Korean dental association
• /
• v.52 no.6
• /
• pp.363-369
• /
• 2014

The cutaneous sinus tract is an uncommon disease. It is difficult to diagnose exactly of odontogenic cutaneous sinus tract for dentists or dermatologists except experienced clinicians or previously known clinicians. Many patients may be treated with repeated surgical excisions, biopsies, and antibiotic medications, but most of them could be frustrated with the recurrence of disease. There are several methods for diagnosis of odontogenic cutaneous sinus tract - such as GP cone tracing, conventional computed tomography(CT), periapical x-ray imaging, and cone beam computed tomography(CBCT). This case report describes the diagnosis and treatment of odontogenic cutaneous sinus tract that referred from medical doctors.

• Archives of Craniofacial Surgery
• /
• v.16 no.2
• /
• pp.63-66
• /
• 2015

Background: Preauricular sinuses represent a common congenital abnormality in children. Classically, a preauricular sinus manifests as a small opening, usually near the anterior limb of ascending helix. The difficulty in the surgical treatment of preauricular sinus is the high recurrence rate. The aim of this article is to review the outcomes of preauricular sinus and to introduce our surgical technique and its prognosis. Methods: A single-institutional retrospective review was performed for all patients who had undergone excision of congenital periauricular sinus between October 2007 and April 2014. Medical records were reviewed for demographic information, wound complication, and recurrence rate. The sinus tract was visualized with the aid of preoperative dye instillation and intraoperative probe insertion. The skin next to the sinus opening was incised elliptically, and the tract itself was dissected medially to the end of the sinus tract and posteriorly to the cartilage of the ascending helix. Results: The review identified 44 patients for a total of 57 preauricular sinus tracts. The mean age at time of operation was 16.3 years with a range from 9 months to 65 years. Unilateral preauricular sinus tract was present in 31 patients (11 right and 20 left preauricular tract), and 13 patients had bilateral sinus tract. None of the patients had experienced wound issues postoperative, and there were no recurrent sinus tract formation or infection. Conclusion: Using a combination of dye instillation, probe insertion, and modified dissection, we were able to achieve a recurrence free series of preauricular sinus tract excision among a heterogenous group of patients. A large patient series is necessary to replicate the results of this study.

• Archives of Plastic Surgery
• /
• v.38 no.4
• /
• pp.523-526
• /
• 2011

Purpose: The odontogenic sinus and fistulous tracts is the most common draining sinus and fistulous tract of the head and neck region. These are often misdiagnoses by clinicions who are not familiar with cutaneous sinus, since most of patients do not have dental symptoms. Here we present two cases of odontogenic cutaneous sinus tract which have been diagnosed after excision of epidermal cyst. Methods: Two patients who presented with an odontogenic sinus tract draining to the skin at our institusion during the two years were enrolled in this study. We reviewed all the medical records of the patients and literature about odontogenic cutaneous sinus tract. Results: Odontogenic cutaneous sinus tracts of our cases were healed after treatment of periapical odontitis and extraction of the carious tooth. Conclusion: The cutaneous sinus tract of dental origin is well documented condition. But its diagnosis is not always easy unless the clinicians consider the possibility of its dental origin. An understanding of the pathogenesis of odontogenic cutaneous sinus tract will lead to early correct diagnosis and proper treatment without unnecessary surgery.

• Archives of Plastic Surgery
• /
• v.37 no.6
• /
• pp.827-830
• /
• 2010

Purpose: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. Methods: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. Results: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. Conclusion: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

• Korean Journal of Head & Neck Oncology
• /
• v.17 no.2
• /
• pp.234-237
• /
• 2001

Pyriform sinus fistula is a rare anomaly arising from 3rd or 4th branchial apparatus and has been recognized as one cause of acute suppurative thyroiditis or acute deep neck infection. Pyriform sinus fistula must be considered when a clinician is encountered recurrent left lower neck abscess and a history of repeated incision and drainage. The confirmation of the diagnosis is made when the fistula tract is identified on a barium swallow study and when the internal orifice of the fistula is found at the apex of pyriform sinus on laryngoscopic examination. A complete excision of the fistula tract has been proposed as a treatment of choice. However, in some cases it is very difficult to resect the tract completely because of severe inflammation and repeated drainage procedure. We present three cases of pyriform sinus fistula which are successfully treated by laryngomicroscopic chemocauterization using synthetic fibrin and $AgNO_3$.

• Archives of Craniofacial Surgery
• /
• v.18 no.1
• /
• pp.1-4
• /
• 2017

Frontal sinus outflow tract (FSOT) injury may occur in cases of frontal sinus fractures and nasoethmoid orbital fractures. Since the FSOT is lined with mucosa that is responsible for the path from the frontal sinus to the nasal cavity, an untreated injury may lead to complications such as mucocele formation or chronic frontal sinusitis. Therefore, evaluation of FSOT is of clinical significance, with FSOT being diagnosed mostly by computed tomography or intraoperative dye. Several options are available to surgeons when treating FSOT injury, and they need to be familiar with these options to take the proper treatment measures in order to follow the treatment principle for FSOT, which is a safe sinus, and to reduce complications. This paper aimed to examine the surrounding anatomy, diagnosis, and treatment of FSOT.

• Archives of Plastic Surgery
• /
• v.38 no.1
• /
• pp.73-76
• /
• 2011

Purpose: Congenital midline upper lip sinus is a rare lesion. There are two postulates that can account for the formation of the upper lip sinus based on two major theories of the development of the face: the fusion theory and the merging theory. However, congenital midline lower lip sinus is very rarely reported and described. We report a case of a congenital midline sinus of the lower lip in a 6-year-old female. Methods: A 6-year-old girl presented with a nipple like swelling on the midline lower lip. Physical examination revealed about $5{\times}5$ mm protruding round mass with a just small opening that was non-tender to palpation. The mass was not associated with any skin changes. It umbilicated at the apex and contains a fistulous tract, discharging clear fluid. Only, simple radiologic finding shows bony spur on the lower one third of mandibular symphsis. Results: A small transverse ellipse is made around the opening and elevated mass with sharpe dissection. The tract is excised using the probe and dye as the guide. The tract was extended to periosteum of the lower one third of the mandible. The tract and involved periosteum were excised en bloc, and removed protrusion of the mandibular bone using diamond burr. Microscopic examination of the resected sinus revealed the fistulous tract itself, consisting of fibrous connective tissue covered with cornified stratified squamous epithelium, was observed in the center of the sample. In 6 months follow-up, This patient had a good result was obtained by the method of fistulectomy alone. Conclusion: Midline cranoifacial fistulas represent rare lesions resulting from abnormal fusion of embryologic structures. Our case report describes the excision of a congenital midline sinus of the lower lip in a 6-year-old female. This case represents the first report of a lower lip sinus presenting in a girl as a mass in the skin of the chin with extension to the midline of the mandible. However, the etiology of this rare congenital sinus remains obscure.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.2
• /
• pp.151-188
• /
• 2021

Spinal dysraphic lesions due to focal nondisjunction in primary neurulation are commonly encountered in paediatric neurosurgery, but the "fog-of-war" on these conditions was only gradually dispersed in the past 10 years by the works of the groups led by the senior author and Prof. Kyu-Chang Wang. It is now clear that limited dorsal myeloschisis and congenital spinal dermal sinus tract are conditions at the two ends of a spectrum; and mixed lesions of them with various configurations exist. This review article summarizes the current understanding of these conditions' embryogenetic mechanisms, pathological anatomy and clinical manifestations, and their management strategy and surgical techniques.

• Archives of Craniofacial Surgery
• /
• v.13 no.1
• /
• pp.57-59
• /
• 2012

Purpose: Congenital sinus of the upper lip is extremely rare and only 3 cases have been reported domestically. We report a case of congenital sinus of midline upper lip, which was found in an adolescent patient. Methods: A 14-year-old girl presented with a small pit on midline of the upper lip, which was visible at birth. The patient had never been treated for the congenital sinus because it was asymptomatic. Surgical excision under local anesthesia was performed. Results: The sinus had a tract extending into 5 mm posteroinferior and had not penetrated the oral cavity. Histological examination showed a fistulous tract lined by keratinized squamous epithelium. After complete excision, there was no recurrence and we obtained a satisfactory cosmetic result. Conclusion: Congenital sinus of the midline upper lip is extremely rare. This is a special case that is reported because it did not cause symptoms for the patient until she reached adolescence.

• Korean Journal of Head & Neck Oncology
• /
• v.12 no.1
• /
• pp.47-51
• /
• 1996

Malignant tumors of the sinonasal tract constitute about 2% of those arising in the head and neck. Exposure to industrial fumes has been associated with an increased incidence of this malignant tumor. Early symptomatology of this cancer is identical to the symptomatology seen in benign conditions, such as swelling on forehead, headache, diplopia, and rhinorrhea. Thereby, delayed diagnosis leads to poor prognosis. Squamous cell carcinoma is the most common malignancy of the sinonasal tract, constituting about 80%, and primary carcinoma of the frontal sinus is extremely rare. Recently, authors experienced a case of primary carcinoma of the frontal sinus in a 60 year old male and performed transcranial resection. Now we report this case with brief review of literatures.