Oroantral fistula and genian mucosal flap: a review of 25 cases.

UNLABELLED: The oroantral fistula is a pathological connection between the maxillary sinus and with the oral cavity. The condition mostly follows dental extraction.

AIM: To present the experience of 25 cases.

MATERIAL AND

METHODS

Retrospective cases between 1996-2000. The ORL examination included nasal or sinusal endoscopy, a CT scan and histopathological analysis.

RESULTS

Twenty-five cases were found: ten 2nd molar cases, eight 1st molar cases, six 2nd premolar cases, and one canine case. All patients underwent a Caldwell-Luc operation plus excision of the epithelium lining the fistula, that was then completely covered by a flap of mucosa rotated from the genian region.

DISCUSSION: In cases of major fistulae a bone autograft taken from the anterior sinus wall was used. Bacterial cultures (n=19) revealed streptococus pneumoniae (13), haemophillus influenza (6), Moraxella catharralis (2) and staphylococus aureus (2). Aspergillus niger was found in one case presenting as a "fungic ball".

CONCLUSIONS

The only case of surgical failure, after 30 days postoperatively, was reoperated, using a bone graft. After a 6-month follow up all of the patients progressed satisfactorily, including the reoperated patient.