Use of otoscope as a diagnostic and therapeutic aid in umbilical pilonidal sinus: a novel technique. Niger

Abstract

Introduction: Umbilical disorders are frequently encountered in general surgical practice. Although the sacrococcygeal region is the most common site for pilonidal sinus disease, it can be seen occasionally in periumbilical area. Treatment is mostly conservative for umbilical pilonidal sinus in contrast to the sacrococcygeal sinus where it is always surgical. In the era of endoscopy and minimally invasive surgery, we describe the use of otoscope as a novel technique for the diagnosis and treatment of umbilical pilonidal sinus.

Subject and Method: In this prospective study, patients with a clinical suspicion of umbilical pilonidal sinus were included and diagnosis was confirmed on the basis of otoscopic finding. All patients were planned for conservative management i.e. extraction of hair fragments with the help of an otoscope followed by oral antibiotics treatment. On follow-up, response of treatment was noted by evaluation of symptoms and otoscopic examination.

Result: Total 15 patients were included in this study. By using otoscope for removal of hair fragments from umbilical sinus, we found successful result in all patients with conservative treatment.

Discussion: In umbilical pilonidal sinus, the success of conservative treatment depends on the effective extraction of hair and maintenance of personal hygiene by the patient. Our study showed 100% successful result of conservative treatment, probably due to proper and complete extraction of hair fragment with the help of the otoscope.

Conclusion: Otoscopic examination and hair extraction for umbilical pilonidal sinus is a simple, cost‑effective, and easy treatment that can be done in the outpatient department and does not require any formal training for its use.

Keywords: Conservative management, otoscope, pilonidal sinus, umbilicus