鼻旁牙源性皮肤瘘管的诊断与治疗──附2例报道和文献复习

目的 归纳面部牙源性皮肤窦道的临床特点和治疗经验。方法 报道因上颌侧切牙病变所引起的鼻旁皮肤瘘管２例，并对相关文献资料进行了复习。治疗措施包括彻底清理牙髓牙体病变和面部皮肤疹管及肉芽组织切除，必要时拔除病牙。结果 面部皮肤瘘管的鉴别诊断应首先考虑牙髓牙体病变。对于面部皮肤单发的慢性化脓性瘘管，应常规行上颌骨和下颌骨影像学检查，以明确诊断。结论 面部牙源性皮肤瘘管的复发误诊和牙髓牙体疾病治疗不彻底密切相关。

Diagnosis and treatment of the odontogenic cutaneous fistula in the perinasal region -a re- port of 2 cases and review of literatures

Objective To characterize the clinical features and to explore, proper treat- ments of odontogenic cutaneous fistula in the region of face. Method Two cases of extraoral fis- tula in the perinasal region secondary to periapical lesions of the lateral maxillary incisors were re- ported, and the recent literatures were also reviewed. Treating measure involve thorough re- moval of pathological changes in the pulp and the cutaneous fistula in the face and granulation tis- sues, and removing the diseased teeth if. necessary. Result The two cases were both cured with- out further recurrence. Conclusion The dental causes should always be suspected in the differ- entiated diagnosis of the odontogenic cutaneous fistula in the face. In the presence of a single chronic suppurative draining lesion of the face, it is very important to perform a radiologic exami- nation of the maxillary and mandibular regions to promptly exclude a possible odontogenic origin. The recurrence of odontogenic cutaneous fistula in the face was closely associated with the misdi- agnosis and inadeguate treatment of the odontogenic diseases.