Oroantral fistula and genian mucosal flap: a review of 25 cases.
The oroantral fistula is a pathological connection between the maxillary sinus and with the oral cavity. The condition mostly follows dental extraction.


OBJECTIVE
To present the experience of 25 cases.


METHODS
Retrospective cases between 1996-2000. The ORL examination included nasal or sinusal endoscopy, a CT scan and histopathological analysis.


RESULTS
Twenty-five cases were found: ten 2nd molar cases, eight 1st molar cases, six 2nd premolar cases, and one canine case. All patients underwent a Caldwell-Luc operation plus excision of the epithelium lining the fistula, that was then completely covered by a flap of mucosa rotated from the genian region.


CONCLUSIONS
In cases of major fistulae a bone autograft taken from the anterior sinus wall was used. Bacterial cultures (n=19) revealed streptococus pneumoniae (13), haemophillus influenza (6), Moraxella catharralis (2) and staphylococus aureus (2). Aspergillus niger was found in one case presenting as a "fungic ball".


CONCLUSIONS
The only case of surgical failure, after 30 days postoperatively, was reoperated, using a bone graft. After a 6-month follow up all of the patients progressed satisfactorily, including the reoperated patient.
Meirelles
Roberto Campos
RC
Universidade Estado Rio de Janeiro, RJ, Brazil. rcmeirelles@gmail.com
Neves-Pinto
Roberto Machado
RM
D004724:Endoscopy; D006801:Humans; D009957:Oroantral Fistula / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome