Abstract
Extraoral sinus tract often poses a diagnostic challenge to the clinician owing to its rare occurrence and absence of symptoms. The accurate diagnosis and comprehensive management are inevitable as the aetiology of such lesions is often masked and requires holistic approach. The present case report encompasses the management of an extraoral discharging sinus tract at the base of the right nostril in a chronic smoker. The lesion which was earlier diagnosed to be of nonodontogenic origin persisted even after erratic treatment modalities. Our investigations showed the aetiology of sinus tract to be odontogenic. Initially, a five-step program as recommended by the Agency for Health Care Research and Quality was used for smoking cessation followed by root canal therapy (RCT) and surgical management of the sinus tract. The patient has been under stringent follow-up and no reoccurrence has been noted.
Highlights
An oral infection may originate in the dental pulp and extend into the periradicular tissues, or it may originate in the superficial periodontal tissues subsequently dispersing through the spongy bone
Cutaneous sinus tract of odontogenic origin is rather uncommon and may manifest on adjacent structures like facial skin, maxillary sinus, orbit, and nostril and may involve distant structures like cavernous sinus that may lead to fatal outcomes [2, 3]
Nasal sinus tract of dental origin may or may not present associated dental pain that often brings about a complex state of diagnostic and management perplexities for the clinicians [4, 5]
Summary
An oral infection may originate in the dental pulp and extend into the periradicular tissues, or it may originate in the superficial periodontal tissues subsequently dispersing through the spongy bone Thereafter, it may perforate the outer cortical bone and spread in various tissue spaces or discharge onto a free mucous membrane or skin surface [1]. Nasal sinus tract of dental origin may or may not present associated dental pain that often brings about a complex state of diagnostic and management perplexities for the clinicians [4, 5]. Failure to diagnose such lesions can lead to inadvertent treatment. The current case report describes the management of a previously misdiagnosed persistent nasal sinus tract in a chronic smoker patient
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