A Rare Case of Chronic Genian Fistula with Oral Mucosal Hair Follicle Inclusion: Case Report and Review of the Literature

Edmond Daniel Ciora^1,2Mariana Ioana Miron^1,2*Andreea Igna³Andreea Georgiana Miron⁴Ciprian Ioan Roi^5,6*Mircea Riviș^5,6

• ¹University Clinic of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041, Timișoara, Romania
• ²Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300070, Timișoara, Romania
• ³Pediatric Dentistry Research Center, University Clinic of Pediatric Dentistry, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041, Timișoara, Romania
• ⁴Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; Pathological anatomy resident, Timisoara Municipal Emergency Clinical Hospital, Timișoara, Romania
• ⁵University Clinic of Anesthesiology and Oral Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041, Timișoara, Romania
• ⁶Research Center of Dento-Alveolar Surgery, Anesthesia and Sedation in Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041, Timișoara, Romania

Background: This report describes a rare case of chronic genian fistula associated with inclusion of oral mucosal hair follicle. Ectopic hair growth in the oral cavity is extremely rare and is typically associated with grafting techniques. The presence of a chronic extraoral fistula with intraoral hair follicle inclusion is exceedingly uncommon and poses diagnostic and therapeutic challenges. Case presentation: A 73-year-old male presented to the Oral and Maxillofacial Surgery Department in Timișoara (Romania) with a chronic cutaneous fistula in theof right lower cheek regionthe right cheek, unresponsive to antibiotics and without signs of dental or sinus origin. Clinical examination revealed a 0.5 cm cutaneous opening and a filamentous, hair-like structure emerging intraorally from the right maxillary alveolar crest. A submucosal fibrotic tract was palpable, and although the fistula was not clearly visible on CBCT due to its soft tissue nature, imaging confirmed the absence of bony or odontogenic involvement. Given the clear clinical presentation, surgical excision was performed under local anesthesia. Intraoperatively, a keratinized, hair-bearing tract traversing the cheek to the alveolar process was excised en bloc. Healing was uneventful, and no recurrence was observed at 14 days. Conclusion: This is one of the few reported cases of a genian fistula with intraoral hair follicle inclusion in a patient without prior facial surgery. The case highlights the importance of integrating clinical, radiologic, and histopathologic findings in diagnosing and managing rare fistulous tracts.