Diagnosis and Management of oro-antral fistula: Case series and review. (August 2022)

• Record Type: Journal Article
• Authors: Azzouzi, Asma; Hallab, Lamiae; Chbicheb, Saliha
• Is Part Of: International journal of surgery case reports. Volume 97(2022)
• Publication Date: 2022-08
• Subjects: Case series -- Oro-antral communications -- Oro-antral fistula -- Diagnosis -- Advanced buccal flap -- Buccal fat pad flap; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107436
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: The oro-antral communication (OAC) is a pathological opening between the maxillary sinus and the oral cavity. When it does not close spontaneously or if it is not treated, it remains permeable and epithelializes to develop into an oro-antral fistula (OAF) and can cause maxillary sinusitis. Cases presentation: The authors present through 5 clinical cases the different steps of the surgical protocols opting for the buccal fat pad flap and the advanced buccal flap to treat OAF/OAC. Clinical discussion: Surgical closure of the OAC within 48 h is recommended to avoid complications. Several alternative techniques have been described over the years for the management of the OAC and OAF, with their advantages and limitations. The most commonly used surgical flaps are of two types: the advanced buccal flap and the buccal fat pad (BFP) flap. Conclusion: The adequate availability of the advanced buccal flap and the buccal fat pad (BFP) flap in the majority of patients, the easy handling, the minimal donor site morbidity as well as the excellent blood supply make them perfect flaps for the closure of OAF/OAC. However, follow-up remains a key point and very important to avoid complications. The present case series was limited by the small number of patients and the authors recommend a study with larger groups. Highlights: Surgical closure of the oro-antral communication within 48 hours is recommended to avoid complications. Oro-antral fistula should be managed promptly by creating a barrier between oral cavity and maxillary sinus to prevent maxillary sinusitis. Successful closure of oro-antral fistula or communication depends on compliance with the indications and surgical protocol. Follow-up remains very important to avoid complications.