Fistole oro-antrali: approccio terapeutico combinato fra chirurgo orale e otorinolaringoiatra

Objectives

Oroantral fistulas consist of osteomucosal communications between the oral cavity and the maxillary sinus, which do not usually resolve spontaneously. In most cases, surgery is performed via a transoral approach and the fistula is closed with local flaps, but the results are often unsatisfactory. This case report shows that proper management of these fistulas depends largely on the functional integrity of the ostiomeatal complex.

Materials and methods

We present the case of a patient with an oroantral fistula. Several transoral attempts to close the fistula had failed. The endoscopic-radiological work-up revealed blockage of the ostiomeatal complex, so the patient underwent functional endonasal endoscopy.

Results

The procedure was effective in rehabilitating the ostiomeatal complex, and spontaneous closure of the oroantral fistula was observed three months after surgery.

Conclusions

This experience suggests that successful management of an oroantral fistula requires a complete multidisciplinary work-up (radiological, ENT, odontoiatric) before transoral surgical closure is attempted.