Endoscopic Repair of Persistent Oroantral Communications Using the Caldwell-Luc Approach

Area of Science:

• Otolaryngology
• Oral and Maxillofacial Surgery
• Endoscopic Surgery

Background:

• Oro-antral fistulas (OAFs) are abnormal communications between the oral cavity and the maxillary sinus, often resulting from dental extractions or trauma.
• Traditional surgical repair methods can be invasive and associated with complications.
• Endoscopic techniques offer a minimally invasive alternative for OAF management.

Purpose of the Study:

• To describe a novel endoscopic technique for the surgical management of oro-antral fistulas.
• To evaluate the efficacy and feasibility of this technique in a series of patients.

Main Methods:

• A cohort of 24 patients with OAFs underwent surgical treatment between May 2011 and November 2014.
• The procedure involved endonasal endoscopic examination and partial inferior uncinectomy to identify the natural maxillary sinus ostium.
• Through this tract, a curved aspirator was used to remove obstructing tissues. The Caldwell-Luc approach facilitated exploration and clearance of the maxillary sinus, preserving ostial patency.
• Bone from the anterior maxillary sinus wall was harvested via the surgical tract for fistula obliteration.

Main Results:

• The described endoscopic technique was successfully applied to 24 patients.
• The method allowed for thorough endoscopic exploration and clearance of the maxillary sinus, including removal of infected tissues and polyps.
• Natural patency of the maxillary sinus ostium was achieved.
• Graft harvesting from the anterior maxillary sinus wall was feasible through the surgical access.

Conclusions:

• The novel endoscopic technique provides an effective and minimally invasive approach for treating oro-antral fistulas.
• This method facilitates direct visualization, clearance of sinus pathology, and autologous graft harvesting for successful fistula closure.