Submental cutaneous sinus tract of mandibular second molar origin

Area of Science:

• Dentistry
• Oral and Maxillofacial Surgery
• Dermatology

Background:

• Cutaneous sinus tracts in the submental region can be misdiagnosed, often mistaken for conditions like thyroglossal fistulas.
• Odontogenic infections, particularly from mandibular molars, are a potential cause of orofacial skin lesions.

Observation:

• A case report details a 53-year-old man with a chronic submental cutaneous sinus tract misdiagnosed as a thyroglossal fistula.
• Sinus tract angiography identified the origin as apical periodontitis of the left mandibular second molar (tooth 37).

Findings:

• The sinus tract, lined with granulation tissue, healed after tooth extraction and extraoral lesion excision.
• Histological examination confirmed the non-epithelial nature of the tract, revealing a submental sinus tract drainage pathway.

Implications:

• Dental evaluation, including all mandibular teeth, is essential for diagnosing submental cutaneous sinus tracts.
• Sinus tract angiography aids in identifying the pathway and associated teeth.
• Treating odontogenic cutaneous sinus tracts requires eliminating the infection source.