Effective treatment protocol of oroantral fistula: case series study
강동우, 윤필영, 김영균,
소속 상세정보
강동우 ( Kang Dong-Woo ) - Seoul National University Bundang Hospital Section of Dentistry Department of Oral and Maxillofacial Surgery
윤필영 ( Yun Pil-Young ) - Seoul National University Bundang Hospital Section of Dentistry Department of Oral and Maxillofacial Surgery
김영균 ( Kim Young-Kyun ) - Seoul National University Bundang Hospital Section of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 1025720190380030073
Abstract
Introduction: Closure of the oroantral fistula with chronic maxillary sinusitis is very difficult to treat and has a high rate of relapse.
Methods: 10 patients for treatment of oroantral fistula from 2009 to 2018 were studied retrospectively. Patients were diagnosed using clinical symptoms and medical history, panorama, and CT, and the treatment for sinusitis was first done and after the sinusitis was extinguished, the surgery of oroantral fistula was performed. The surgical method was performed with Caldwell-Luc approach to manage the infection in maxillary sinus, elevation of sinus floor, closure of perforated sinus membrane, bone graft, and local flap. Postoperative complications and progress were investigated by medical records and radiographic findings.
Results: 10 patients who had 11 surgical sites on maxillary sinus was included. The average age was 53.9±9.9 years old, all male patients. The duration of the symptoms varied from 2 weeks to 36 months. 1 patient was operated under local anesthesia and 9 were under general anesthesia. From the first surgery, 7 patients had a surgery which is included sinus bone graft, and all used a mixture of bone substitutes, including autogenous bone. 3 people received surgeries such as local flap, palatal splint, or infection control without any bone graft, but 2 of them reoccurred and were successfully closed through additional surgery including additional bone graft. The tissue adhesive was used in 8 people, and the collagen membrane in 7. Complications were 1 trismus, 2 delayed sinusitis, 1 wound dehiscence, and 1 implant failure. Finally, the oroantral fistula was 100% closed.
Conclusions: In order to effectively treat the oroantral fistula, clinicians should accurately diagnose natural ostium, residual bone, and sinus membrane with CT. Before the main surgery, thorough infection control of chronic sinusitis and various surgical methods are applied to prevent recurrence and bring a good progress.
키워드
Maxillary sinusitis; Oroantral fistula; Oroantral sinus tract
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