齒源性皮膚瘻管：病例報告

皮膚瘻管之感染源若是齒源性的如齲齒、牙周病與牙齒外傷等造成的，時常因為無正確的診斷而延遲治療，甚或進行一些不有效或不正確的治療。本篇報告描述一個十歲女孩齒源性瘻管的病例，其一度被診斷為表皮囊腫，在全身麻醉下進行外科切除手術後又於局部麻醉下進行門診清創手術但均無法有效改善症狀。後來感染源被重新診斷為來自於下顎第一大臼齒因齲齒引起的牙髓壞死，經過正確有效的根管治療，感染的病灶很快地在一個月內痊癒，後續追蹤了五個月，預後良好無復發情形。若能夠有早期正確的診斷與處置這些病灶，可讓病人避免一些不必要的抗生素處置與手術治療。

關鍵字

皮膚瘻管；牙髓壞死；齒源性感染；表皮囊腫

並列摘要

Cutaneous fistulas may be an infection from dental origin such as dental caries, periodontal disease, and dental trauma, Delayed or ineffective treatment of cutaneous fistulas is often due to misdiagnosis and the absence of dental symptoms. This article describes a case of a ten-year-old girl with odontogenic cutaneous fistula. She was first diagnosed as an epidermal cyst and went through surgical removal under general anesthesia followed by debridement under local anesthesia. However, both of which failed to improve the symptom of fistula. She was transferred to dental department for evaluation. The source of infection was then re-diagnosed as dental pulp necrosis caused by dental caries in the mandibular right first molar. After being treated with root canal therapy in the first molar, the infected cutaneous fistula was recovered quickly within one month. The cutaneous lesion was completely healed at five months recall without any signs of recurrence. It is concluded that having correct diagnosis for these kinds of cases is important so that patients can avoid unnecessary surgical interventions.

並列關鍵字

Cutaneous fistula ； Pulp necrosis ； Dental origin infection ； Epidermal cyst

國際替代計量

齒源性皮膚瘻管：病例報告

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