Sinocutaneous Fistula Secondary to Chronic Frontal Rhinosinusitis: Case Series and Literature Review

Abstract

The purpose of this study was to describe the clinical features of a series of patients in whom sinocutaneous fistula developed in the setting of chronic frontal sinusitis. We performed a retrospective case review of patients with sinocutaneous fistula. Clinical records, imaging, and operative reports were carefully examined. A complete literature review for relevant studies was performed to examine similar cases and possible pathophysiology. Three patients with sinocutaneous fistula secondary to frontal sinusitis were identified. All patients underwent successful endoscopic sinus surgery with computer-assisted stereotactic localization and closure of the fistula. Development of sinocutaneous fistula secondary to frontal sinusitis is rare, but still occurs in the modern antibiotic era. Definitive management of this disease process requires 1) a frontal sinusotomy ensuring patency of the outflow tract and 2) fistula excision and multilayer closure.