title: Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy.
abstract: OBJECTIVE
  A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated.
  
  
  METHODS
  Twenty-six consecutive patients (15 males and 11 females) aged 28-72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management.
  
  
  RESULTS
  At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund-Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups.
  
  
  CONCLUSIONS
  Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery,Army Hospital (Research and Referral),Delhi,India.
authors.forename: A K
authors.initials: AK
authors.lastname: Mishra
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery,Army Hospital (Research and Referral),Delhi,India.
authors.forename: V R
authors.initials: VR
authors.lastname: Sinha
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery,Army Hospital (Research and Referral),Delhi,India.
authors.forename: A
authors.initials: A
authors.lastname: Nilakantan
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery,Army Hospital (Research and Referral),Delhi,India.
authors.forename: D K
authors.initials: DK
authors.lastname: Singh
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D014663:Nasal Decongestants / Q000627:therapeutic use*; D009957:Oroantral Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011183:Postoperative Complications / Q000628:therapy*; D012220:Rhinitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction
chemical_list: D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D007093:Imidazoles; D014663:Nasal Decongestants; D008012:Lidocaine; C009695:xylometazoline
keywords: Antibiotics; Oroantral Fistula; Sinusitis; Tooth Extraction