Submandibular Cutaneous Draining Sinus Tract from Mandibular Osteomyelitis

Abstract

Chronically draining cutaneous sinus tracts are frequently misdiagnosed and incorrectly treated. Diagnostic errors can result in multiple surgical excisions and biopsies, long-term antibiotic therapy, and even radiation therapy or electrodessication. The most common cause of skin drainage is a chronically infected tooth. A sinus tract from a mandibular osteomyelitis is very rare and hard to detect. A 36-year-old woman was presented to the hospital with a 1.5 year history of purulent discharge from a cutaneous sinus present at submandibular region. The patient had received three excisions and drainage procedures but the drainage recurred. The neck computed tomography revealed a focal disruption with radiolucence on the posterior surface of the left inferior mandibular body. The disease was completely cured after the excision of sinus tract and thorough curettage of the affected lesion of the mandible. We report a cutaneous submandibular draining sinus tract that developed from a mandibular osteomyelitis unrelated to a tooth inflammation. (Korean J Otorhinolaryngol-Head Neck Surg 2009;52:549-51)