Background: A major difference between the treatment of the skin lesions and the odontogenic and non-odontogenic sinuses. We aimed to analyze a substantial number of consecutive causes in order to clinical suspicion in the differential diagnoses may be correctly weighted. Materials and methods: The material of this research consisted of 40 patients. A complete history is collected from the patients with the duration and the site of the sinus present, the patient was examined for factors of the fistulas and sinuses and its associations, and patient having any concomitant lesions, a medical consultation done for opinion and management. Clinical examination with facial fistulas and sinuses was mandatory to avoid any mistakes that may occur. A treatment plan was contemplated regarding a conservative line will be followed or a surgical intervention was indicated results. Results: The common etiological causes: congenital and acquired causes. Fifteen patients have eighteen facial sinuses and fistulas (40.9%) developed because of non-odontogenic infections, fifteen patients had fifteen facial sinuses (34%) because of odontogenic infections, four congenital sinuses (9%) developed at three patients, two patients with two facial sinuses (4.5%) due to tumor growth, three patients with three facial fistulas (6.8%) due to traumatic causes and one patient with one facial sinus (2.2%) because of Actinomycosis and unknown cause for each. Conclusions: The maxillofacial surgeon should be aware of causes of whether developmental anomalies, deep seated infections, epithelization of the tract, insufficient or inadequate drainage, deep lining foreign bodies and certain types of infections.
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