Management of oro-antral fistula: Two case reports and review

Abstract

Oro-antral Communication is an unnatural communication between the oral cavity and maxillary sinus and when it fails to close spontaneously, it remains patent and is epithelialized so that oro-antral fistula develops. It is a common occurrence following removal of maxillary premolars and molars because of anatomic proximity of root apices of these teeth and maxillary antrum. Signs and symptoms of oro-antral fistula varies from free escape of fluids, pain, pus leakage, voice alteration, to pan-sinusitis. Several surgical options exist for its management, in particular the buccal fat pad technique, which has proved to be an effective and a reliable technique. We report in this article two-succefull cases of oro-antral fistula managed with buccal fat pad.

Evaluation of Bioxclude Amnion Chorion Membrane in the Repair of Oro-Antral Communication (Clinical and Radiographical Study)

“…The oroantral communication (OAC) is the connection between the maxillary sinus and the oral cavity. If left untreated, it might lead to oroantral fistula or maxillary sinusitis (20). Oroantral communication normally occurs when the maxillary molar teeth are removed.…”

Diagnosis and Management of oro-antral fistula: Case series and review

“…The clinical diagnosis of OAC/OAF is usually based on subjective and objective findings, patients may be asymptomatic [11] , but most complain of symptoms that may be acute or chronic. Acute symptoms include epistaxis, passage of fluid or air through the OAC/OAF, pain in and around the affected sinus area, voice alteration, and wheezing when speaking [2] . Chronic symptoms include alleviated pain, free drainage of fluids through the oral fistula, mucopurulent nasal discharge, antral polyps may be visualized through the defect at a later stage, postnasal drip, bad intraoral odor and taste, voice alterations and earache [9] , [11] .…”

“…To validate the clinical findings, radiological investigation of the OAC and OAF site is necessary [2] , [11] , [13] , [14] . A panoramic radiograph and a blond CT scan can determine the size, location, and degree of sinus involvement [13] .…”

“…The proximity of the maxillary sinus during extraction of antral teeth, most often the upper molars and premolars, is the main reason for this complication (48 %). Interventions on cystic or tumoral pathologies (18.5 %), or following a trauma (7.5 %) can lead to the creation of an oral-sinus communication [2] . Other causes include osteoradionecrosis, infection, sinusitis, osteomyelitis, during implant surgery or following dehiscence after implant failure and sometimes as a complication of the Caldwell-Luc procedure [1] , [3] .…”

Reporte De Cierre De Fístula Buco-Sinusal Con Cuerpo Adiposo Y Colgajo Vestibular

“…Quando a CBS não consegue fechar espontaneamente ou se não tratada, o tecido poderá se epitelizar e evoluir para a fístula oroantral (FOA) ou fístula buco-sinusal (FBS) e doença sinusal crônica. 1,2,3,4,5,6,7,8,9 Além da técnica cirúrgica traumática, a CBS pode ser ocasionada por excesso de curetagem alveolar após a extração, após condições infecciosas como leishmaniose, goma sifilítica e noma, osteomielite, sequelas de radioterapia como osteorradionecrose, traumas faciais como do tipo Le Fort I, fratura da tuberosidade, deslocamento de implante, deiscência após falha do implante, complicações no procedimento de Caldwell-Luc ou remoção de cistos e tumores maxilares. Alguns fatores de risco também podem estar interligados na causa dessa complicação, como: a idade do paciente, anatomia e posição da raiz em relação ao seio, falta de espessura do assoalho sinusal, aposição direta do revestimento maxilar acima dos dentes posteriores, por reabsorção óssea, quando acometido por doença periodontal e quando há uma extensa pneumatização do seio maxilar.…”