Four-Layered Closure of Large Oroantral Fistula: A Case Report

Year 2019, Volume: 2 Issue: 2, 40 - 44, 01.05.2019

Elshan Muradov , Mehmet Barış Şimşek Mert Gündoğdu

Abstract

 Oroantral communication is the consequence of a loss of continuity between the maxillary sinus and the oral cavity. Sinus floor perforation occurs due to the close anatomical relationship between this structure and the antral teeth and to procedures such as extraction of posterior teeth, trauma, orthognatic surgery, osteomyelitis, gummatous lesions, periapical surgery, cyst and neoplasm removal, the placement of implants in the posterior segment of the maxilla and an improper surgical approach, as well as brusqueness in the use of instruments. Extraction of maxillary posterior teeth is the most common aetiology. We present a case of  45 year old male with oroantral fistula(OAF) which was caused by left maxillary second molar extraction.The defect was closure by four-layered technique, which combined collagen membrane, pedical palatal connective tissue, pedical buccal fat pad flap and buccal advancement flap.After 6 months follow up complete epithelization of operation site was observed.

Keywords

Oroantral fistula, Sinus membrane, Buccal fat pad, Buccal advancement flap, Palatal rotated connective tissue, Collagen membrane

GENİŞ OROANTRAL FİSTÜLÜN DÖRT KATMANLI DOKUYLA KAPATILMASI: VAKA RAPORU

Abstract

  Oroantral ilişki  maksiller sinüs ve ağız boşluğu arasında bulunan açıklıktır. Sinüs tabanı perforasyonu posterior dişlerin çekilmesi, travma, ortognatik cerrahi, osteomiyelit, gummatöz lezyonlar, periapikal cerrahi, kist ve neoplazm çıkarılması, implantların yerleştirilmesi ve alet kullanımında olan keskinlik gibi  prosedürlere bağlı olarak ortaya çıkar. Maksilla posterior dişlerin çekilmesi oroantral fistül oluşumunun en sık görülen etiyolojisidir. Bu makalede 45 yaşında erkek hastanın sol maksilla  ikinci molar dişin çekiminden sonra oluşan  oroantral fistül (OAF) vakası sunulacaktır.  Defekt, kolajen membran, rotasyonal palatal bağ dokusu, bukkal yağ ve bukkal ilerletme flebi ile  kombine edilen dört katmanlı teknikle kapatılmıştır. 6 ay sonra operasyon sahasının tam epitelizasyonu gözlenilmiştir.

Keywords

Oroantral fistül, Sinüs membranı, Bukkal yağ fleb, Bukkal ilerletme flebi, Palatal bağ dokusu, Kollajen membran

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