Treatment Outcome of Oroantral Fistula

Seo, Mincheol; Kim, Yong Jae; Kim, Jae Ho; Lee, Bong Jae

Abstract

BACKGROUND AND OBJECTIVES: Epithelialization of the fistula in chronic cases of oroantral fistula hinders natural healing of its opening. This requires surgical repair in most cases. We aimed to evaluate the treatment results of 12 cases managed by different surgical methods. MATERIALS AND METHOD: Twelve patients with oroantral fistula were managed in our hospital between March 1991 and July 2000. The male to female ratio was 4:8 and their ages ranged from 27 to 63 years with the mean of 46 years. Medical records of oroantral fistula were reviewed for the evaluation of causes, treatment methods, and final outcomes.
RESULTS
Eight fistulas developed after tooth extraction due to dental problem or sinusitis, and four fistulas originated from postoperative mucocele of the maxillary sinus. The first upper molar was most frequently involved, followed by the second premolar. One patient was cured by conservative management alone and eleven patients underwent Caldwell-Luc's operation, fistulectomy, and flap surgery. Two fistulas were repaired with the use of palatal mucosal rotation flap, and nine fistulas with the use of buccal mucosal advancement flaps resulting in successful outcomes.
CONCLUSION
Tooth extraction and postoperative mucocele are the two common causes of oroantral fistula. Caldwell-Luc's operation with fistulectomy and flap surgery for repairing the opening of the fistula resulted in cure without recurrence.