Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T01:07:22.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy

Published online by Cambridge University Press:  06 May 2016

A K Mishra ,
V R Sinha ,
A Nilakantan  and
D K Singh
A K Mishra*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
V R Sinha
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
A Nilakantan
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
D K Singh
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
*
Address for correspondence: Col Awadhesh Kumar Mishra, Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research & Referral), Delhi Cantt, Delhi – 110010, India Fax: +91 11 256 98691 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated.

Methods:

Twenty-six consecutive patients (15 males and 11 females) aged 28–72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management.

Results:

At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund–Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups.

Conclusion:

Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.

Keywords

SinusitisOroantral FistulaTooth ExtractionAntibiotics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 6 , June 2016 , pp. 545 - 553
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Franco-Carro, B, Barona-Dorado, C, Martinez-Gonzalez, MJ, Rubio-Alonso, LJ, Martinez-Gonzalez, JM. Meta-analytic study on the frequency and treatment of oral antral communications. Med Oral Patol Oral Cir Bucal 2011;16:682–7Google Scholar
2 Mast, G, Otto, S, Mucke, T, Schreyer, C, Bissinger, O, Kolk, A et al. Incidence of maxillary sinusitis and oroantral fistulae in bisphosphonate-related osteonecrosis of the jaw. J Craniomaxillofac Surg 2012;40:568–71Google Scholar
3 Punwutikorn, J. Clinically significant oroantral communications – a study of incidence and site. Int J Oral Maxillofac Surg 1994;23:19–21 Google Scholar
4 del Rey-Santamaría, M, Valmaseda Castellón, E, Berini Aytés, L, Gay Escoda, C. Incidence of oral sinus communications in 389 upper third molar extraction. Med Oral Pathol Oral Cir Bucal 2006;11:334–8Google Scholar
5 Abuabara, A, Cortez, AL, Passeri, LA, de Moraes, M, Moreira, RW. Evaluation of different treatments for oroantral/oronasal communications: experience of 112 cases. Int J Oral Maxillofac Surg 2006;35:155–8CrossRefGoogle ScholarPubMed
6 Anavi, Y, Gal, G, Silfen, R, Calderon, S. Palatal rotation-advancement flap for delayed repair of oroantral fistula: a retrospective evaluation of 63 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:527–34Google Scholar
7 Awang, MN. Closure of oroantral fistula. Int J Oral Maxillofac Surg 1988;17:110–15CrossRefGoogle ScholarPubMed
8 Yilmaz, T, Suslu, AE, Gursel, B. Treatment of oroantral fistula: experience with 27 cases. Am J Otolaryngol 2003;24:221–3Google Scholar
9 Brook, I. Sinusitis of odontogenic origin. Otolaryngol Head Neck Surg 2006;135:349–55CrossRefGoogle ScholarPubMed
10 Lin, PT, Bukachevsky, R, Blake, M. Management of odontogenic sinusitis with persistent oroantral fistula. Ear Nose Throat J 1991;70:488–90Google Scholar
11 Nemec, SF, Peloschek, P, Koelblinger, C, Mehrain, S, Krestan, CR, Czerny, C. Sinonasal imaging after Caldwell-Luc surgery: MDCT findings of an abandoned procedure in times of functional endoscopic sinus surgery. Eur J Radiol 2009;70:31–4Google Scholar
12 Andric, M, Saranovic, V, Drazic, R, Brkovic, B, Todorovic, L. Functional endoscopic sinus surgery as an adjunctive treatment for closure of oroantral fistulae: a retrospective analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:510–16Google Scholar
13 Hajiioannou, J, Koudounarakis, E, Alexopoulos, K, Kotsani, A, Kyrmizakis, DE. Maxillary sinusitis of dental origin due to oroantral fistula, treated by endoscopic sinus surgery and primary fistula closure. J Laryngol Otol 2010;124:986–9CrossRefGoogle ScholarPubMed
14 Joe Jacob, K, George, S, Preethi, S, Arunraj, VS. A comparative study between endoscopic middle meatal antrostomy and Caldwell-Luc surgery in the treatment of chronic maxillary sinusitis. Indian J Otolaryngol Head Neck Surg 2011;63:214–19Google Scholar
15 Stammberger, H, Posawetz, W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990;247:63–76 Google Scholar
16 Meltzer, EO, Hamilos, DL, Hadley, JA, Lanza, DC, Marple, BF, Nicklas, RA et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004;114:155–212 CrossRefGoogle ScholarPubMed
17 Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinology 1993;31:183–4Google Scholar
18 Gillett, S, Hopkins, C, Slack, R, Browne, JP. A pilot study of the SNOT 22 score in adults with no sinonasal disease. Clin Otolaryngol 2009;34:467–9Google Scholar
19 Yeolekar, AM, Dasgupta, KS, Khode, S, Joshi, D, Gosrani, N. A study of SNOT 22 scores in adults with no sinonasal disease. J Rhinol -Otol 2013;1:6–10 Google Scholar
20 Guven, O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg 1998;26:267–71CrossRefGoogle ScholarPubMed
21 Hernando, J, Gallego, L, Junquera, L, Villarreal, P. Oroantral communications: a retrospective analysis. Med Oral Patol Oral Cir Bucal 2010;15:499–503 Google Scholar
22 Visscher, SH, van Minnen, B, Bos, RR. Closure of oroantral communications: a review of the literature. J Oral Maxillofac Surg 2010;68:1384–91Google Scholar
23 Messerklinger, W. Endoscopy of the Nose. Baltimore: Urban and Schwarzenberg, 1978 Google Scholar
24 Rodrigues, MT, Munhoz, ED, Cardoso, CL, de Freitas, CA, Damante, JH. Chronic maxillary sinusitis associated with dental impression material. Med Oral Patol Oral Cir Bucal 2009;14:163–6Google Scholar
25 Fusetti, S, Emanuelli, E, Ghirotto, C, Bettini, G, Ferronato, G. Chronic oroantral fistula: combined endoscopic and intraoral approach under local anesthesia. Am J Otolaryngol 2013;34:323–6CrossRefGoogle ScholarPubMed
26 Kamadjaja, DB. The role of proper treatment of maxillary sinusitis in the healing of persistent oroantral fistula. Dent J 2008;41:128–31Google Scholar
27 Lee, KC, Lee, SJ. Clinical features and treatments of odontogenic sinusitis. Yonsei Med J 2010;51:932–7Google Scholar
28 Jain, MK, Ramesh, C, Sankar, K, Lokesh Babu, KT. Pedicled buccal fat pad in the management of oroantral fistula: a clinical study of 15 cases. Int J Oral Maxillofac Surg 2012;41:1025–9Google Scholar
29 Abad-Gallegos, M, Figueiredo, R, Rodríguez-Baeza, A, Gay-Escoda, C. Use of Bichat's buccal fat pad for the sealing of orosinusal communications. A presentation of 8 cases. Med Oral Patol Oral Cir Bucal 2011;16:215–19Google Scholar
30 Scattarella, A, Ballini, A, Grassi, FR, Carbonara, A, Ciccolella, F, Dituri, A et al. Treatment of oroantral fistula with autologous bone graft and application of a non-reabsorbable membrane. Int J Med Sci 2010;7:267–71CrossRefGoogle ScholarPubMed
31 Haas, R, Watzak, G, Baron, M, Tepper, G, Mailath, G, Watzek, G. A preliminary study of monocortical bone grafts for oroantral fistula closure. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:263–6Google Scholar
32 Candamourty, R, Jain, MK, Sankar, K, Babu, MR. Double-layered closure of oroantral fistula using buccal fat pad and buccal advancement flap. J Nat Sci Biol Med 2012;3:203–5Google Scholar
33 Kitagawa, Y, Sano, K, Nakamura, M, Ogasawara, T. Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:409–15Google Scholar
34 Saleh, EA, Issa, IA. Closure of large oro-antral fistula using autograft septal cartilage: a new technique. Bull Alexandria Fac 2006;42:963–4Google Scholar
35 Cankaya, AB, Erdem, MA, Cakarer, S, Isler, SC, Demircan, S, Oral, CK. Reliability of two surgical methods for oroantral communication closure; a clinical study of 20 patients. Otolaryngology 2012;2:1–4 Google Scholar
36 Borgonovo, AE, Berardinelli, FV, Favale, M, Maiorana, C. Surgical options in oroantral fistula treatment. Open Dent J 2012;6:94–8CrossRefGoogle ScholarPubMed
37 Logan, RM, Coates, EA. Non-surgical management of an oroantral fistula in a patient with HIV infection. Aust Dent J 2003;48:255–8Google Scholar
38 Ehrl, PA. Oroantral communication. Epicritical study of 175 patients, with special concern to secondary operative closure. Int J Oral Surg 1980;9:351–8Google Scholar
39 Hadley, JA, Mosges, R, Desrosiers, M, Haverstock, D, van Veenhuyzen, D, Herman-Gnjidic, Z. Moxifloxacin five-day therapy vs. placebo in acute bacterial sinusitis. Laryngoscope 2010;120:1057–62Google Scholar
40 Picirillo, JF, Merritt, MG, Richards, ML. Psychometric and clinimetric validity of the 20-item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg 2002;126:41–7CrossRefGoogle Scholar
41 Hopkins, C, Gillett, S, Slack, R, Lund, VJ, Browne, JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 2009;34:447–54CrossRefGoogle ScholarPubMed