Original Article

The combined endoscopic radical antrostomy and buccal fat pad (BFP) approach is effective in managing oroantral fistulae

Matthew Noussair, Eugene Wong, Anthony Naim, Faruque Riffat


Background: Oroantral fistulae (OAF) are a recognised complication that may occur asa result of dental extraction. OAF can cause significant quality of lifereduction if left untreated as they predispose patients to chronic bacterialmaxillary sinusitis. As a result, effective management of the sinusitis as wellas defect closure are essential in the management of these patients. We aimedto evaluate the effectiveness of a combined approach endoscopic maxillaryantrostomy and a buccal fat pad (BFP), three layered fistula defect closure forOAF.
Methods: Consecutivepatients who underwent a combined endoscopic radical antrostomy and BFPperformed at a Private Surgical Hospital facility were identified from hospitaldatabases. Retrospective review of prospectively collected data of eachpatient’s medical records was then performed. Demographics collected includedage, sex, presenting symptoms and indication for surgery. Outcomes assessed at6 weeks postoperatively included symptom resolution, fat pad breakdown rate,fistula closure rate, complication rate and need for revision surgery.
Results: A total of 15patients (age 50.1±10.3 years; 60% male) were included in the study. Allpatients were discharged the following day with no immediate surgicalcomplications. All patients experienced successful closure of OAF with completeresolution in symptoms of maxillary sinusitis. No fat pads experiencedbreakdown and no patients required further revision surgery.
Conclusions: Based on a smallretrospective cohort, the combined Endoscopic Radical Antrostomy and BFPapproach appears to be effective and safe in the management of OAF.

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