Oro-Antral Fistula Repair With Different Surgical Methods: a Retrospective Analysis of 147 Cases

STATEMENT OF THE PROBLEM: An oro-antral fistula (OAF) creates a passage for oral microbes into maxillary sinus with numerous possible complications. PURPOSE: This retrospective study evaluates the success of three different surgical techniques of OAF repair. MATERIALS AND METHOD: Records of patients that were treated for OAF repair were retrieved and reviewed. Data recorded were patients’ age, gender, etiology, size, location, duration, and method of repair. According to the surgical technique used to repair the OAF, patients were divided into three groups including buccal flap, palatal flap, and buccal fat pad. All of the patients were locally anesthetized with 2% lidocaine and 1/100000 or 1/80000 epinephrine. Then the edges of the fistula were excised and fistula wall was dissected in a stitched layer by three surgical methods. The three groups were compared concerning the success or failure of surgical technique based on complete closure of OAF after three months postoperatively. RESULTS: 147 patients (116 males and 31 females) with adequate records were included in the study. The surgical methods used in patients were, buccal flap in 59 (40.1%), buccal fat pad in 42 (40.8%), and palatal flap in 28 (19%) individuals. Success rates of these techniques were significantly different. Buccal fat pad was the most successful flap (98.3%), followed by buccal flap (89.8%), and palatal flap (85.7%). The most common cause of OAF in this group of patients was dental extraction. CONCLUSION: Buccal fat pad flap seems to be one of the best treatments for the closure of OAF lager than 5 mm.