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<p>A congenital cheek fistula is a rare condition, and only four cases have been known to the best of our knowledge. A 4.5-year-old female child reported a pinpoint cutaneous fistula that was barely noticeable until purulent discharge on manual manipulation of the cheek since birth. The examinations led to exclusion of odontogenic cause and fistulography led to a provisional diagnosis of the congenital cheek fistula. The differential diagnosis includes odontogenic infections, first or second branchial cleft sinus/fistula, Vander Woude syndrome, and congenital salivary fistula of the parotid gland. After informed consent, surgical excision of the fistula followed by histopathological examination was carried out, and an uneventful follow-up for 6 years. This congenital cheek fistula does not fit into any known categories of first or second branchial cleft sinus/fistula. There is a lack of literature regarding the pathogenesis of this malformation, but it has been suggested to be incomplete transverse facial clefts. These cheek fistulae have not been well reported in the literature, and maxillofacial surgeons should be aware of their diagnosis and management procedures. This condition, classified as Tessier no. 7, can manifest as an innocuous yet persistent fistula near the angle of the mouth, often misdiagnosed or overlooked.</p>

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A Rare Congenital, Non-odontogenic Cheek Fistula in a Paediatric Patient: Probable Incomplete Transverse Facial Cleft?

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Hitesh Chander Mittal,
  • Sunil Yadav,
  • Himanshu Shekhawat,
  • Dhiraj Parihar

摘要

A congenital cheek fistula is a rare condition, and only four cases have been known to the best of our knowledge. A 4.5-year-old female child reported a pinpoint cutaneous fistula that was barely noticeable until purulent discharge on manual manipulation of the cheek since birth. The examinations led to exclusion of odontogenic cause and fistulography led to a provisional diagnosis of the congenital cheek fistula. The differential diagnosis includes odontogenic infections, first or second branchial cleft sinus/fistula, Vander Woude syndrome, and congenital salivary fistula of the parotid gland. After informed consent, surgical excision of the fistula followed by histopathological examination was carried out, and an uneventful follow-up for 6 years. This congenital cheek fistula does not fit into any known categories of first or second branchial cleft sinus/fistula. There is a lack of literature regarding the pathogenesis of this malformation, but it has been suggested to be incomplete transverse facial clefts. These cheek fistulae have not been well reported in the literature, and maxillofacial surgeons should be aware of their diagnosis and management procedures. This condition, classified as Tessier no. 7, can manifest as an innocuous yet persistent fistula near the angle of the mouth, often misdiagnosed or overlooked.