A higher glabellar soft tissue cushion is associated with a lower incidence of pilonidal sinus disease

Mounting evidence links cut occipital hair fragments to the formation of pilonidal sinus disease (PSD). Anatomical variations in the shape of the dorsal crest between the occiput and the upper intergluteal fold may be crucial in the downward movement of hair to the glabella sacralis region. This study aims to investigate the shape and height of the glabellar cushion and their potential influence on the development of PSD. We established a method for capturing the shape of the thoracolumbar back down to the intragluteal fold using a structured light 3D scanning device. The soft tissue surface contour of this region was measured. We developed algorithms to extract the width and shape of the canal between the erector trunci, as well as the height of the glabellar cushion. Included were 155 individuals, 94 PSD patients and 61 without PSD. Glabellar height differs significantly between PSD and non-PSD cohorts. In total, PSD was associated with a 7.8 ± 3.7 mm glabellar cushion, while non-PSD patients exhibited a 9.7 ± 3.8 mm glabellar cushion (p = 0.0021). In male PSD patients, the glabellar height was 7.8 ± 3.7 mm (mean ± SD), while in female PSD patients it was 7.7 ± 3.6 mm. Conversely, non-PSD males had a glabellar cushion height of 8.9 ± 2.7 mm, and non-PSD females of 10.5 ± 4.4 mm. A higher glabellar region is associated with a lower incidence of pilonidal sinus disease. Therefore, elevating and bolstering the glabellar region could be beneficial for preventing recurrence.