title: Use of Pedicled Nasoseptal Flap for Pathologic Oroantral Fistula Closure.
abstract: Oroantral fistula (OAF) is a pathologic, epithelialized communication between the oral cavity and the maxillary sinus. OAF most commonly results from posterior maxillary tooth or molar extraction owing to proximity of the dental roots to the maxillary antrum and the thinness of the adjacent antral floor. It also can arise secondary to implant and orthognathic surgeries, cyst and tumor removal, dental infection, trauma, or as a sequela of radiation therapy. Communications larger than 5 mm are less likely to heal spontaneously and can epithelialize, forming an OAF. When locoregional flaps and grafts are not ideal or have failed, but primary OAF closure is mandated, surgical options are unclear. This report describes a novel method for autologous tissue flap coverage from the nasal septum, pedicled off the posterior septal artery, for successful extension to, and closure of, OAFs.
authors.affiliation: Resident, Department of Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Noel
authors.affiliation: Consultant, Department of Otolaryngology, Singapore General Hospital, Singapore.
authors.forename: Neville W
authors.initials: NW
authors.lastname: Teo
authors.affiliation: Assistant Professor, Department of Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA.
authors.forename: Vasu
authors.initials: V
authors.lastname: Divi
authors.affiliation: Assistant Professor, Department of Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA. Electronic address: JNayak@ohns.stanford.edu.
authors.forename: Jayakar V
authors.initials: JV
authors.lastname: Nayak
mesh_terms: D064592:Autografts / Q000637:transplantation*; D003646:Debridement / Q000379:methods; D015921:Dental Implants / Q000009:adverse effects; D019232:Dental Restoration Failure; D004724:Endoscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000637:transplantation*; D009300:Nasal Septum / Q000601:surgery; D009957:Oroantral Fistula / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation*
chemical_list: D015921:Dental Implants