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Chronic oroantral fistula: combined endoscopic and intraoral approach under local anesthesia
Stefano Fusetti1, Enzo Emanuelli, Cristina Ghirotto
1Unit of Maxillofacial Surgery, Department of Neurosciences, University Hospital of Padova, Padova, Italy.
Objective:
To evaluate the outcome of combined surgical treatment of oroantral communications associated with chronic maxillary sinusitis.
Patients And Methods:
8 consecutive patients affected by complicated oroantral fistula were included in the study. The protocol consisted of: clinical, endoscopic and radiological preoperative evaluation (panoramic tomogram and computed tomography); systemic antibiotic and steroid therapy 2 weeks before surgery; one-stage surgical procedure under local anaesthesia consisting in uncinectomy with enlargement of the osteomeatal complex through endoscopic nasal approach associated with the closure of the oroantral communication by means of a mucoperiosteal flap; postoperative antibiotic and cortisone-based therapy. Follow-up consisted of weekly clinical evaluation during the first month, and nasal endoscopy at 3, 8 and 24 weeks after surgery.
Results:
After surgical treatment, all patients were symptom-free and had no endoscopic and radiological evidences of maxillary sinusitis at the 6-month follow-up. No recurrent oroantral fistulas were found.
Conclusions:
The current prospective study showed that a one-stage, combined endoscopic and intraoral approach under local anaesthesia represents a feasible and minimally invasive procedure for the long-term effective treatment of chronic complicated oroantral communications. Moreover, it represents an easily applicable approach also in outpatient clinics with minor patient discomfort.
