Maxillary sinusitis of dental origin due to oroantral fistula, treated by endoscopic sinus surgery and primary fistula closure.
OBJECTIVE
To present the current treatment approach for oroantral fistula causing maxillary sinusitis.


METHODS
Case series. Four cases of oroantral fistula (diameters: 6, 9, 11 and 13 mm) due to chronic maxillary sinusitis were treated by excision of all diseased oroantral fistula tissue, followed by endoscopic creation of a large middle antrostomy and closure of the fistula using buccal flaps. A synthetic surgical glue and local alveolar bone were used.


RESULTS
Patients were followed up for six months to three years; all were considered cured.


CONCLUSIONS
Most surgeons use buccal or palatal flaps, combined with the Caldwell-Luc procedure, to treat chronic odontogenic sinusitis and to repair fistulae more than 5 mm in diameter. This study supports the hypothesis that an endoscopic technique could be successfully used in patients with oroantral fistula causing chronic maxillary sinusitis of dental origin, instead of the Caldwell-Luc procedure, at least in patients with a small to medium-sized oroantral fistula.
Hajiioannou
J
J
ENT department, General Hospital of Pireus, Athens, Greece. irakliotis@yahoo.com
Koudounarakis
E
E
Alexopoulos
K
K
Kotsani
A
A
Kyrmizakis
D E
DE
D000328:Adult; D002908:Chronic Disease; D003487:Cyanoacrylates / Q000627:therapeutic use; D003646:Debridement; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000150:complications* / Q000175:diagnosis; D009957:Oroantral Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D014081:Tooth Extraction / Q000009:adverse effects*
D003487:Cyanoacrylates