|Hideo Takenoshita and Toshiyuki Yamamoto*|
|Corresponding Author: Toshiyuki Yamamoto, MD, PhD, Department of Dermatology, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan. Tel./Fax: +81.24.547.1307 E-mail: firstname.lastname@example.org|
|Received: April 22, 2015; Accepted: May 21, 2015; Published: Aug 25, 2015;|
|Citation: Yamamoto T & Takenoshita H (2015) Efficacy of cone-beam computed tomography for the diagnosis of external dental fistula. Dermatol Clin Res, 1(2): 31-33|
|Copyrights: ©2015 Yamamoto T & Takenoshita H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
fistula often presents with facial sinus, and patients visit dermatology
clinics. Usually, diagnosis is not
difficult by orthopantomography. We present a case of external dental fistula
which was not detected by orthopantomography, but examination by cone-beam
computed tomography (CT) revealed a small sequestrum.
A 62-year-old woman was referred to our hospital, complaining of a nodular lesion on her right cheek, with 2 months’ duration. Previously, she visited otolaryngology department, and needle biopsy showed no malignancy. Administration of antibiotics resulted in no effects. On the initial visit to our department, a physical examination showed a reddish dimpled nodule located on the right cheek (Figure 1). Clinical diagnosis was external dental fistula, however, examination by pantomography did not detect any abnormalities. Histological examination showed non-specific granulation with dense infiltration of inflammatory cells composed of lymphocytes, neutrophils, histiocytes and plasma cells in the whole dermis (Figure 2). Tissue cultures for bacteria, mycobacterium tuberculosis and non-tuberculous mycobacterium were all sterile. Also, polymerase chain reaction (RCR) analysis for mycobacterium tuberculosis and non-tuberculous mycobacterium were negative. Laboratory examination showed no abnormalities including liver and kidney function, and tuberculin test revealed negative reaction. Cone-beam computed tomography revealed the presence of a small sequestrum (Figure 3). Surgical treatment with sequestrectomy resulted in improvement with scar within 3 months.
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