Oro_antral fistula is an epithelized unnatural communication between maxillary sinus antrum and oral cavity.
- mainly surgical as in dental extraction of second premolar or first molar
- Accidental as in penetrating wounds.
- Cancer maxilla.
- History of dental extraction.
- Nasal regurgitation of liquids.
- Unilateral nasal discharge.
- Bad taste in mouth.
- The fistula may be visible through the oral cavity.
- Purulent discharge seen coming through the fistula into the oral cavity.
- Unilateral purulent offensive nasal discharge.
- CT nose and PNS.
- X-ray panoramic view.
-probing should never be attempted.
-any associated sinusitis should be treated before any surgical intervention to improve success rates.
depend on the time of diagnosis and size of defect.
- Heals spontaneous if the defect is less than 2mm
- Direct primary repair with suture is done if discovered immediately after injury.
- Refreshing of edges is done in cases discovered late and if the defect is smaller than 1 mm the do curettage and direct repair with sutures and if the defect is larger than 1 mm then cover the oral opening of fistula with a flap of palatal or buccal origin.