Treatment of oroantral fistula: Experience with 27 cases

Purpose: To review patients with chronic oroantral and oronasal fistula who underwent surgical correction. Material and Methods: Twenty-seven patients with chronic oroantral and oral fistula who underwent surgical correction in the Hacettepe University Faculty of Medicine Department of Otorhinolaryngology Head and Neck Surgery between 1968 and 2001 were reviewed retrospectively. Results: Local mucosal flaps were used for surgical correction. The underlying factors were tooth extraction in 13 patients (48%), tumor in 5 (18.5%), osteomyelitis in 3 (11%), Caldwell-Luc procedure in 2 (7.5%), trauma in 2 (7.5%), dentiginous cyst in 1(3.7%), and correction of septal perforation in 1 (3.7%). Among the fistulas, 23 were oroantral, 3 were oroantronasal, and 1 was oronasal, respectively. Two patients required revisional repairment. The surgical procedure failed in 1 diabetic patient and 3 patients with prior history of external radiotherapy. Conclusion: Tooth extraction was the most common etiologic factor, and malignancy should be excluded in all patients. The outcome may not be satisfactory in patients with systemic disease and in patients with history of radiotherapy. Multiple surgical interventions may be necessary only on rare occasions. (C) 2003 Elsevier Inc. All rights reserved.