Presentation
Neck swelling and submental discharge.
Patient Data
Periapical lucencies at 37 and 46 with surrounding sclerotic rim.
T2 hyperintense material fills the periapical lucency about the root of 37, and is contiguous with enhancing sinus tract that extends through a defect in the inferior lingual cortex to the skin, with the tract lying just anterior to the left submandibular gland and a cutaneous submental opening to the left of midline. The sinus tract lies inferolateral to mylohyoid muscle belly.
Loss of normal mandibular bone marrow signal surrounding 46 with loss of adjacent lingual and buccal mandibular cortex and adjacent soft tissue thickening and enhancement compatible with inflammatory tissue.
Case Discussion
Odontogenic cutaneous fistalas occur secondary to chronic dental infection.
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