Difference between Sinus Tract and Fistula in Surgery
How Sinus Tract Differs from Fistula in Surgical Context
While both sinus tracts and fistulas involve abnormal connections in the body, they differ significantly in structure, origin, and treatment approach
A sinus tract is a rarely occurring single blind-ended tubular structure formed as an extension from the deeper tissues to the skin. On the other hand, a fistula is an abnormal passage between two epithelialized structures (e.g., organs, vessels), such as between two organs or an organ and the skin.
What is the Relation Between Sinus Tract and Fistula?
Sometimes, a fistula may develop if an untreated sinus tract erodes into an adjacent structure. In contrast, to treat a fistula, a controlled sinus tract may be created to allow for drainage and healing of the pus.
Difference Between Sinus Tract and Fistula
Here is a list of differences between the sinus tract and the fistula:
| Parameters | Sinus Tract | Fistula |
| Symptoms | Depending on the location, the symptoms of the sinus tract appear. For example, pilonidal sinus tract symptoms include pain while standing or sitting, sore skin in the surrounding area, pus or blood drainage and swelling of the cyst. Odontogenic sinus tract symptoms include cutaneous lesions, swelling in the cheeks, and periodic pus discharge.
| Depending on which part of the body it affects, fistula symptoms differ. For example, in a chest fistula, the oesophagus connects with the trachea or windpipe. This results in excessive coughing, chest infection and shortness of breath. |
| Cause | A sinus tract can develop due to surgical injury, infection and collection of necrotic materials. For example, chronic periapical abscess leads to an odontogenic sinus tract. | Fistulas can occur because of infections, injuries, or inflammations. |
| Severity | The severity of the sinus tract includes persistent drainage or pain, chronic infection such as osteomyelitis (bone infection). | The severity of fistulas ranges from mild to life-threatening. It mainly depends on the location, cause and treatment. For example, the mortality rate of enterocutaneous fistulas varies from 6% to 33%. |
| Diagnosis | After evaluating symptoms and the size of the sinus tract, the diagnosis is conducted. For the pilonidal sinus tract, methylene blue is utilised intraoperatively to map the tract for excision. | Usually, after a thorough physical examination, experts diagnose a fistula. These examinations include endoscopic ultrasound, MRI, etc. |
| Treatment | In case of an infected abscess, experts make a small incision to drain the pus. Then, they recommend antibiotics. Treatment of larger abscesses sometimes requires the application of local or general anaesthetics. | Fistulotomy (Surgery) is the first-line treatment for most fistulas. |
Sinus Tract Surgery Types
Here are a few types of sinus tract surgeries to be aware of:
- Pilonidal sinus removal can happen using Limberg flap reconstruction. In this type of surgery, after removing the sinus tract from the bottom, healthy skin replaces the wounded skin.
- Odontogenic sinus tract surgery targets underlying dental infection that causes sinus tract.
Fistula Surgery Types
Some key types of fistula surgery are:
- Tracheo-oesophageal Fistula (TEF) happens mostly in babies. Doctors repair the connection between the trachea and oesophagus to treat TEF.
- Middle/inner ear exploration and patchingtreats Perilymphatic Fistula, where doctors fix a damaged eardrum through a tissue graft.
- Doctors do a fistulotomy to treat anal fistula, an infection near the anus or rectum. Through fistulotomy, a surgeon opens the channel so that the infection can heal.
Even though sinus tracts and fistulas are different and may appear benign at the surface, both can turn into life-threatening issues if not treated in time. People need to stay alert for symptoms and talk to a healthcare professional as soon as they experience symptoms of sinus tract and fistula.
Explore Relevant Symptoms and Conditions
This FAQ page contains information for general purpose only and has no medical or legal advice. For any personalized advice, do refer company's policy documents or consult a licensed health insurance agent. T & C apply. For further detailed information or inquiries, feel free to reach out via email at marketing.d2c@starhealth.in