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Abstract Oroantral Fistula Paraya Assanasen*

*Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Oroantral fistula (OAF) is a pathological connection between the maxillary sinus and the oral cavity.

The condition mostly follows extraction of postcanine teeth in the maxilla because of the close relation- ship between the apex of those teeth and the floor of the maxillary antrum. An accurate history and physical examination and proper investigation should be performed to rule out possible contributing factors, e.g. previous sinonasal infection and inflammation, benign or malignant neoplasms or osteomy- elitis. If these are present, appropriate treatment should be performed before closure is attempted.

Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. Procedures involving local flaps are usually adequate to close minor-to-mo- derate-size defects. The buccal mucoperiosteal advancement flap is the simplest and most effective way of closing OAF. The palatal rotation flap has also been a popular choice. Wound breakdown and flap necro- sis are the most common complications of OAF repair. Careful preservation of the flap’s blood supply and tension-free wound closure are the keys to avoiding these complications.

Key word: oroantral fistula

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610

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Ò. Guven O. A clinical study on oroantral fistulae. J Cranio Maxillofac Surg 1998;26:267-71.

Ú. Rud J, Rud V. Surgical endodontics of upper molars: relation to the maxillary sinus and operation in acute state of infection. J Endod 1998;24:260-1.

√–∫“¬·Õπ∑√—¡∑’Ë¢â“ß≈à“ßÀ√◊Õμ√ß°≈“ß.

°“√ºà“μ—¥ªî¥∑“ß∑–≈ÿμ‘¥μàÕ™àÕßª“°°—∫·Õπ∑√—¡Õ“®∑”

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‚¥¬°«â“π‡¬◊ËÕ∫ÿ√Õ∫Ê √Ÿ∑–≈ÿ·≈â«‡¬Á∫ªî¥∑—π∑’ (√Ÿª∑’Ë Ò).

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- °“√√–∫“¬‚æ√ßÕ“°“»¢â“ß®¡Ÿ°∫√‘‡«≥‚Àπ°·°â¡

∑“ß™àÕß®¡Ÿ°‰¡à¥’ ‡™àπ Õ“®¡’°“√Õÿ¥°—Èπ∫√‘‡«≥ osteomeatal complex À√◊Õ √Ÿ‡®“–·Õπ∑√—¡¢â“ß≈à“ßμ’∫·§∫.

- ‰¡à‰¥â‡Õ“‡π◊ÈÕμ“¬, °√–¥Ÿ°Õ—°‡ ∫μ‘¥‡™◊ÈÕ, ‡¬◊ËÕ∫ÿ‡¡◊Õ°

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°—∫™àÕßª“°ÕÕ° ∑”„Àâ¡’°“√μ‘¥‡™◊ÈÕÀ≈ß‡À≈◊ÕÕ¬Ÿà.

- ·ºàπ∑’Ë„™âªî¥√Ÿ∑–≈ÿ¬“«‰¡àæÕ ∑”„Àâ‡°‘¥§«“¡μ÷ß∑’Ë·º≈

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- „™â«— ¥ÿ‡¬Á∫·º≈™π‘¥≈–≈“¬‰¥â„π‡«≈“ —Èπ ∑”„Àâ≈–≈“¬

À“¬‰ª°àÕπ∑’Ë·º≈®–μ‘¥ π‘∑.

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Û. Morgan MK, Aldren CP. Oroantral fistula: a complication of transantral ligation of the internal maxillary artery for epistaxis. J Laryngol Otol 1997;111:468-70.

Ù. Lawson W, Reino AJ. Oroantral fistula. In: Gates GA, editor.

Current therapy in otolaryngology-head and neck surgery. St. Louis:

Mosby; 1998. p. 408-11.

ı. Baumann A, Ewers R. Application of the buccal fat pad in oral

reconstruction. J Oral Maxillofac Surg 2000;58:389-92.

ˆ. el-Hakim IE, el-Fakharany AM. The use of the pedicled buccal fat pad and palatal rotating flaps in closure of oroantral communica- tion and palatal defects. J Laryngol Otol 1999;113:834-8.

˜. Martin-Granizo R, Naval L, Costas A, et al. Use of buccal fat pad to repair intraoral defects: review of 30 cases. Br J Oral Maxillofac Surg 1997;35:81-4.