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Oroantral fistula after a zygomaticomaxillary complex fracture

Zygomaticomaxillary complex (ZMC) fractures account for a substantial proportion of trauma cases. The most frequent complications of maxillofacial fracture treatment are infections and soft tissue flap dehiscence. Postoperative infections nearly always resolve in response to oral antibiotics and loc...

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Autores principales: Ahn, Seung Ki, Wee, Syeo Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cleft Palate-Craniofacial Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615425/
https://www.ncbi.nlm.nih.gov/pubmed/31256562
http://dx.doi.org/10.7181/acfs.2019.00108
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author Ahn, Seung Ki
Wee, Syeo Young
author_facet Ahn, Seung Ki
Wee, Syeo Young
author_sort Ahn, Seung Ki
collection PubMed
description Zygomaticomaxillary complex (ZMC) fractures account for a substantial proportion of trauma cases. The most frequent complications of maxillofacial fracture treatment are infections and soft tissue flap dehiscence. Postoperative infections nearly always resolve in response to oral antibiotics and local wound care. However, a significant infection can cause a permanent fistula. A 52-year-old man visited our clinic to treat an oroantral fistula (OAF), which was a late complication of a ZMC fracture. Postoperatively, the oral suture site dehisced, exposing the absorbable plate. However, he did not seek treatment. After 5 years, an OAF formed with a 2.0× 2.0 cm bony defect on the left maxilla. We completely excised the OAF, harvested a piece of corticocancellous bone from the iliac crest, inserted the harvested bone into the defect, and covered the soft tissue defect with a buccal mucosal transposition flap. Although it is necessary to excise OAFs, the failure rate is higher for large OAFs (> 5 mm in diameter) because of the extensive defect in the underlying bone that supports the overlying flap. Inappropriate management of postoperative wounds after a ZMC fracture can lead to disastrous outcomes, as in this case. Therefore, proper postoperative treatment and follow-up are essential.
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spelling pubmed-66154252019-07-19 Oroantral fistula after a zygomaticomaxillary complex fracture Ahn, Seung Ki Wee, Syeo Young Arch Craniofac Surg Case Report Zygomaticomaxillary complex (ZMC) fractures account for a substantial proportion of trauma cases. The most frequent complications of maxillofacial fracture treatment are infections and soft tissue flap dehiscence. Postoperative infections nearly always resolve in response to oral antibiotics and local wound care. However, a significant infection can cause a permanent fistula. A 52-year-old man visited our clinic to treat an oroantral fistula (OAF), which was a late complication of a ZMC fracture. Postoperatively, the oral suture site dehisced, exposing the absorbable plate. However, he did not seek treatment. After 5 years, an OAF formed with a 2.0× 2.0 cm bony defect on the left maxilla. We completely excised the OAF, harvested a piece of corticocancellous bone from the iliac crest, inserted the harvested bone into the defect, and covered the soft tissue defect with a buccal mucosal transposition flap. Although it is necessary to excise OAFs, the failure rate is higher for large OAFs (> 5 mm in diameter) because of the extensive defect in the underlying bone that supports the overlying flap. Inappropriate management of postoperative wounds after a ZMC fracture can lead to disastrous outcomes, as in this case. Therefore, proper postoperative treatment and follow-up are essential. Korean Cleft Palate-Craniofacial Association 2019-06 2019-06-20 /pmc/articles/PMC6615425/ /pubmed/31256562 http://dx.doi.org/10.7181/acfs.2019.00108 Text en Copyright © 2019 The Korean Cleft Palate-Craniofacial Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Ahn, Seung Ki
Wee, Syeo Young
Oroantral fistula after a zygomaticomaxillary complex fracture
title Oroantral fistula after a zygomaticomaxillary complex fracture
title_full Oroantral fistula after a zygomaticomaxillary complex fracture
title_fullStr Oroantral fistula after a zygomaticomaxillary complex fracture
title_full_unstemmed Oroantral fistula after a zygomaticomaxillary complex fracture
title_short Oroantral fistula after a zygomaticomaxillary complex fracture
title_sort oroantral fistula after a zygomaticomaxillary complex fracture
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615425/
https://www.ncbi.nlm.nih.gov/pubmed/31256562
http://dx.doi.org/10.7181/acfs.2019.00108
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