A Rare Case of Fistula: Nasocutaneous Fistula

Abstract

A three-year-old male patient was brought to our clinic by his family with the complaint of a non-healing wound with discharge on his forehead and the nasal region. He had a history of a fall one-year ago. The patient had recurrent complaints of swelling and hyperemia following this trauma. He had undergone an operation with the pre-diagnosis of foreign body in soft tissue six months ago. However, no foreign body had been detected and the inflamed tissue had been excised and closed again. The swelling and purulent discharge in the region between nose and eye continued after this surgery. The patient underwent an operation and a circular defect 0.5 cm in diameter was detected on the dorsum of the nasal bone and a fistula tract was found to have developed between this defect and the skin between the nose and the eye. A subcutaneous forehead flap without skin tissue was removed including the periosteum from the left part of forehead after excision of the fistula tract. The flap was transferred to the nasal dorsum and the component of the forehead flap including the periosteum was used for reconstruction of the nasal mucosa. The wound healed without any problems and no fistula or infection developed again during the six-month follow-up.