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3 results

  • Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy

  • A K Mishra, V R Sinha, A Nilakantan, D K Singh
  • Journal:
    The Journal of Laryngology & Otology / Volume 130 / Issue 6 / June 2016
    Published online by Cambridge University Press:
    06 May 2016, pp. 545-553
    Print publication:
    June 2016
  • Objective:

    A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated.

    Methods:

    Twenty-six consecutive patients (15 males and 11 females) aged 28–72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management.

    Results:

    At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund–Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups.

    Conclusion:

    Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.

  • Maxillary sinusitis of dental origin due to oroantral fistula, treated by endoscopic sinus surgery and primary fistula closure

  • J Hajiioannou, E Koudounarakis, K Alexopoulos, A Kotsani, D E Kyrmizakis
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 9 / September 2010
    Published online by Cambridge University Press:
    20 May 2010, pp. 986-989
    Print publication:
    September 2010
  • Aim:

    To present the current treatment approach for oroantral fistula causing maxillary sinusitis.

    Design:

    Case series. Four cases of oroantral fistula (diameters: 6, 9, 11 and 13 mm) due to chronic maxillary sinusitis were treated by excision of all diseased oroantral fistula tissue, followed by endoscopic creation of a large middle antrostomy and closure of the fistula using buccal flaps. A synthetic surgical glue and local alveolar bone were used.

    Results:

    Patients were followed up for six months to three years; all were considered cured.

    Conclusion:

    Most surgeons use buccal or palatal flaps, combined with the Caldwell–Luc procedure, to treat chronic odontogenic sinusitis and to repair fistulae more than 5 mm in diameter. This study supports the hypothesis that an endoscopic technique could be successfully used in patients with oroantral fistula causing chronic maxillary sinusitis of dental origin, instead of the Caldwell–Luc procedure, at least in patients with a small to medium-sized oroantral fistula.

  • Oroantral fistula: a complication of transantral ligation of the internal maxillary artery for epistaxis

  • M. K. Morgan, C. P. Aldren
  • Journal:
    The Journal of Laryngology & Otology / Volume 111 / Issue 5 / May 1997
    Published online by Cambridge University Press:
    29 June 2007, pp. 468-470
    Print publication:
    May 1997

  • Transantral ligation of the internal maxillary artery (IMAX) is a well-described option for surgical management of posterior epistaxis not controlled by anterior and posterior packing. Advocates for this procedure argue that it reduces the morbidity, length of hospital stay and financial cost associated with prolonged nasal packing. The procedure is carried out through a Caldwell-Luc approach and the IMAX is clipped in the pterygomaxillary fossa. Fashioning of a nasoantral window is optional and its inclusion usually depends on the integrity of the sinus ostium. The commonest complications of transantral IMAX ligation occur when local structures including the inferior orbital and anterior superior alveolar nerves are damaged. The incidence of oroantral fistula following IMAX ligation is very low but those cases reported have been associated with the failure to create a nasoantral drainage window. We report two cases of persistent oroantral fistula complicating transantral internal maxillary artery ligation. No nasoantral window was fashioned in either of these cases.