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Results for “Oroantral Fistula”

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At least 19 recordsLinked to original sources
PubMed1995

Oral-maxillary sinus fistula (oroantral fistula): clinical features and findings on multiplanar CT.

OBJECTIVE: Oroantral fistula, an abnormal communication between the oral cavity and the maxillary sinus, is infrequently diagnosed radiologically. The purpose of this study was to describe the CT findings and clinical features of oroantral fistula and to show that dental CT multiplanar reformatting programs can be instrumental in diagnosing this condition. SUBJECTS AND METHODS: The study included eight patients with clinically confirmed oroantral fistula or with radiologic evidence of oroantral fistula. Fistula size, degree of alveolar atrophy, nature of maxillary sinus disease, and related dental disease were assessed along with the clinical presentations. RESULTS: The most frequent CT findings were bony discontinuity of the maxillary sinus floor, communication between the oral cavity and the sinus, soft-tissue opacification of the ipsilateral maxillary sinus, focal areas of alveolar atrophy, and associated periodontal disease. In 6 of 8 patients there was 100% opacification of the ipsilateral maxillary sinus, and in 5 of 8 patients the contralateral sinus appeared completely normal. The fistula size ranged from 13.5 mm2 to 189 mm2. CONCLUSION: The appearance of oroantral fistula on multiplanar CT imaging is disruption of the bony floor of the maxillary sinus with soft-tissue opacification of the ipsilateral sinus. Dental reformatted CT can be useful for evaluating patients suspected of having oroantral fistula, and this condition may be found incidentally in patients referred for evaluation for osseointegrated root-form dental implants.

Adult↗
PubMed1988

Closure of oroantral fistula.

Oroantral fistula is an uncommon complication in oral surgery. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. The literature review revealed various procedures for the closure of oroantral fistulas. These procedures may be subdivided into local flap, distant flap and grafting. Procedures involving local flaps are usually adequate to close minor to moderate size defects. Those procedures utilizing the buccal mucoperiosteal flap as the tissue closure include straight-advancement, rotated, sliding and transversal flap procedures; while those involving the palatal mucoperiosteum are straight advancement, rotational-advancement, hinged and island flap procedures. The combinations of various local flaps to strengthen the tissue closure are also being advocated. The advantages and the limitations of these procedures are discussed. Distant flaps and bone grafts are usually indicated in the closure of larger defects in view of their greater tissue bulks. Tongue flaps have superseded extra-oral flaps from extremities and forehead for aesthetic reasons and also in view of their similar tissue replacement. Various tongue flap procedures are described. At present, various alloplastic materials such as gold, tantalum and polymethylmethacrylate are infrequently reported in the closure of oroantral fistulas. However, in the light of successful reports over the use of biological materials, collagen and fibrin, in the closure of oroantral fistulas, there seems to be another simple alternative technique for treating oroantral fistulas.

Bone Transplantation↗
PubMed1995

Competent closure of chronic oroantral fistula with Zenoderm.

Ten patients suffered from chronic oroantral fistula had been closed with Zenoderm (lyophilized porcine dermis) covering the bony defects by 1-2 mm. The Zenoderm was covered by buccal sliding and rotating pedicle palatal flaps after complete resolution of sinusitis and/or infection of the fistula. In nine patients, competent closure of the fistula had been achieved also Zenoderm supported the flaps against negative or positive pressure from the sinus and supported the bony contour. In only one case the Zenoderm was expelled from the tissues due to infection which prevented healing of the flaps; this patient was controlled diabetic. The current study showed that Zenoderm had promising results in closing the chronic oroantral fistula.

Adolescent↗
PubMed2003

Palatal rotation-advancement flap for delayed repair of oroantral fistula: a retrospective evaluation of 63 cases.

OBJECTIVE: To review our 17-year clinical experience with delayed oroantral fistula repair by palatal rotation-advancement flap, and to report its advantages, disadvantages, and complications. STUDY DESIGN: The records of 63 patients with late oroantral fistula treated by palatal rotation-advancement flap from 1984 to 2002 were reviewed. Eleven had undergone unsuccessful closure with a buccal flap. Data recorded were patient age and sex, cause of fistula, signs and symptoms, interval from appearance of fistula to repair, fistula size, radiographic appearance, method of repair, and immediate and late complications. RESULTS: There were 35 women and 28 men aged 21 to 71 years (mean 50.3 years). Surgery was performed 3 months to 20 years after injury (mean 1.8 years). Twenty-four patients had acute maxillary sinusitis and 39 had chronic sinusitis. The main causes of oroantral fistula were extraction of the second and first molars and pathological lesions within the sinus. Average fistula size was 2.3 cm x 1.6 cm. Fifty-one repairs were preceded by Caldwell-Luc operation. All fistulas were successfully closed with the palatal rotation-advancement flap, with minimal complications on long-term follow-up. CONCLUSION: The palatal rotation-advancement flap is recommended for the late repair of oroantral fistula owing to its good vascularization, excellent thickness and tissue bulk, and easy accessibility; it also allows for the maintenance of the vestibular-sulcus depth. It is particularly indicated in cases of unsuccessful buccal flap closure.

Adult↗
PubMed1990

Treatment of an oroantral fistula with chronic sinusitis: a case report.

A patient with an oroantral fistula of seventeen years' duration presented clinically complaining of symptoms suggesting recurring episodes of acute maxillary sinusitis. After control of the acute sinusitis, the defect was repaired using a buccal flap procedure and the sinus was enucleated via a Caldwell-Luc approach. The sinus contents included what appeared to be a chicken bone. The patient healed uneventfully. A discussion of the management of chronic oroantral fistulas and a case report are presented.

Foreign Bodies↗
PubMed1996

Anteriorly based palatal flap for closure of large oroantral fistula.

A technique for closure of large oroantral fistula as a lateral transposition flap with an anteriorly based palatal flap is described. Mucoperiosteum of the posterior third of the hard palate, which is more yielding, is raised to bridge large defects without leaving any considerable exposed raw area. The technique is particularly useful in the correction of defects at the tuberosity region.

Humans↗
PubMed2003

A preliminary study of monocortical bone grafts for oroantral fistula closure.

Sinus floor elevation has become a standard procedure in patients affected by severe maxillary atrophy, before implant placement, provided that the maxillary sinus is intact and uninfected. In the case of an oroantral fistula, simple soft tissue closure may interfere with the process of elevating the Schneiderian membrane. Total regeneration of the bony sinus floor is necessary to prevent disruption of the sinus membrane. In this study, 5 patients with oroantral fistulae of different causes were treated with autogenous monocortical bone blocks harvested from the chin. Press-fit closure for bony repair of the basal maxilla was sufficient in 3 of them. Two patients needed additional internal graft fixation. In the meantime, the 3 aforementioned patients underwent a successful sinus lift procedure. The use of a monocortical bone block for the closure of an oroantral fistula is recommended before internal sinus augmentation.

Adult↗
PubMed2004

Use of the serratus anterior free flap to treat a recurrent oroantral fistula.

We describe the successful use of the serratus anterior free muscle flap to obliterate a recurrent oroantral fistula in a 39-year old male who 19 years before this surgery had sustained a high velocity impact to his right face with multiple subsequent corrective surgeries. There was no complication from the serratus anterior free flap surgery and no postoperative scapular winging. The serratus anterior muscle is a versatile flap and ideal for various defects. It should be considered for obliteration of oroantral fistulas when no local or regional tissue is available because of previous surgery or trauma.

Adult↗
PubMedDate not supplied

[Surgical correction of oroantral fistulas with integration of mandibular bone].

OBJECTIVE: The goal of this study was to formulate a proposal for an alternative surgical technique for treating >3 mm oroantral fistulas by integration of mandibular bone, in an attempt to decrease complications due to its invasive nature. MATERIAL AND METHODS: An observational, descriptive and longitudinal cohort study was carried out in the Maxillofacial Oral Surgery Department in the Specialty Hospital of the 21st Century National Medical Center of the Mexican Institute of Social Security in Mexico City. Sample patients with a diagnosis of oroantral fistula from January 1984 to December 1999 were selected. Surgical correction under general anesthesia was performed with the integration of mandibular osseous graft. Patients were followed postoperatively for 4 years. RESULTS: Of the 22 patients, 13 were male and 9 female, and all were between 25 and 45 years old (average: 35.5 years). They were treated by application of osseous external mandible graft. In most cases, the graft was covered with a sliding mucoperiosteal flap, two were covered with a racquet-type flap and one only one procedure was Von Lagenbeck type because the nasal floor was involved. None of the patients refused the graft. All patients were followed postoperatively, both clinically and radiologically, for 4 years. DISCUSSION: Oroantral communication control is difficult because of mouth fluids, mixed bacterium and a humid environment that promotes development of infection. Therefore, the solution is complicated. As a consequence, it is thought that a simple technique such as the use of mandible graft, which offers advantages over others that are performed such as the application of calotte, rib, iliac crest, and perone grafts, but also implies double surgery in distant anatomic areas with particular complications in each one and a longer surgical time. CONCLUSIONS: Whatever the etiology of the oroantral communication, the fistulas must be treated immediately after diagnosis. Treatment protocol must be established according to the size and location and presence or absence of infectious process. Successful treatment is achieved by this process.

Adult↗
PubMed1995

Technical note: oroantral fistula: improved imaging with a dental computed tomography software program.

Oroantral fistula (OAF) is an uncommon complication in oral surgery. About 5% of all extractions of maxillary premolars or molars may result in communication to the antrum. Small fistulae, 1-5 mm in diameter may close spontaneously, but larger fistulae usually require surgical closure. Pre-operative determination of the size of the fistula is often unreliable leading to difficulties in planning subsequent clinical management. We report a method for the precise determination of the size of the OAF using a dental computed tomography (CT) software program.

Adult↗
PubMed1998

A clinical study on oroantral fistulae.

The report presented is an analysis of 98 patients with an oroantral fistula (OAF). The tooth most frequently involved was the upper second molar, followed by the first molar. The highest incidence was seen in the fourth and third decades of life and the lowest incidence in the second decade. In this study, intercurrent sinusitis was the most obvious cause of the chronic oroantral communication. The closure of OAF is one of the more challenging problems in oral surgery. Long-term successful closure of OAF depends on the technique used, the size and location of the defect, and on the presence or absence of sinus disease. Among the several techniques proposed for treatment of OAFs, in the majority of cases, the buccal advancement flap technique was used in this study. The advantages and limitations of the technique are discussed.

Adolescent↗