Objective: The etiology of primary pilonidal sinus disease (PSD) remains unclear. Prior investigations suggest that sharp fragments from the occiput contribute to the formation of PSD. In 2009 a correlation between PSD and a deeper natal cleft was reported. We investigated the association between intergluteal fold (IGF) depth and PSD risk using a standardized five-step measuring protocol.
Material and methods: Our clinical prospective study included 95 PSD patients and 105 non-PSD individuals, and measurements were taken from the glabella sacralis to the anus in a northern German population.
Results: The mean (± standard deviation) intergluteal depth progressively increased from the intergluteal opening from the sacral glabella at 9.1 (±3.4) mm to a maximum of 62.6 (±10.4) mm. Notably, the deepest point was consistently observed at the anus, where PSD occurrence is rare. No significant difference in IGF depth between PSD and non-PSD patients was found. Additionally, PSD predominantly developed in the proximal (cranial) third of the IGF, despite the maximum depth being in the distal region.
Conclusion: These findings suggest that IGF depth is not a risk factor for PSD.
Keywords: Intergluteal fold depth; PSD; mechanism of disease; natal cleft; pilonidal sinus.
Copyright© 2025 The Author. Published by Galenos Publishing House on behalf of Turkish Surgical Society.