A Sino-orbitocutaneous Fistula from Local (Native) Tonsillectomy: A Case Report

Background: Orbitocutaneous fistula is a known complication of orbital exenteration. Orbitocutaneous fistula arising from a tonsillectomy are quite uncommon. Risk factors for fistula development are sinus diseases, radiotherapy, inadvertent sinus penetration during mid-face and other related surgeries.

Case Report: MS is a 16-year-old girl who presented with swelling of the right side of the face and neck of ten days duration following local tonsillectomy at home. Ocular examination findings showed lid swelling, ecchymosis, pus point in the medial third of the upper lid of the right eye which gave way and formed a sinus tract with the commencement of antibiotics.

Discussion: Although orbitosinocutaneous fistula is uncommon with tonsillectomy however fistulae may develop following poorly performed procedure by a non-professional who may tamper with the sinuses in the course of surgery. Since asepsis was not observed, there may have also been upward track of infection to the orbit.

Conclusion: Orbitosinocutaneous fistula could be a complication of poorly performed tonsillectomy.