Repair of Oroantral Fistulas Using Free Bone and Mucoperiosteal Flaps After Endoscopic Removal of the Medial Wall of the Maxillary Sinus

Abstract

Introduction: Oroantral fistula (OAF) refers to a pathological connection between the oral cavity and maxillary sinus. It may lead to symptoms that include purulent mucus, nasal congestion, facial swelling, bad breath, and nasal regurgitation of food, all of which negatively impact patients’ quality of life. Objective: This study presents a novel approach for OAF repair using a 2-layered structure composed of free bone and a mucoperiosteal flap obtained from the medial wall of maxillary sinus. Materials and methods: Ten OAF patients who underwent repair using this method were retrospectively reviewed between August 2015 and June 2022. Results: The extraction of maxillary molars was the most common cause of OAF. The size of the fistulas ranged from 1×2 mm to 5×8 mm. Nine of the 10 patients achieved successful OAF closure following the initial operation using the 2-layer structure composed of free bone and mucoperiosteal flag. One patient was lost to follow-up. The 9 patients were observed for 6 months to 1 year, and they exhibited no obvious complications or recurrence. Conclusion: The use of free bone and mucoperiosteal flag from the medial wall of maxillary sinus through an endoscope was effective for OAF repair.