Oroantral fistulation

Oroantral fistulas are a pathological communication between the oral cavity and the maxillary sinus (antrum).

Terminology

The term oroantral fistula is similar to but not synonymous with the term oroantral communication (OAC). An oro-antral fistula refers to an "epithelialized" pathological unnatural communication between the oral cavity and the maxillary sinus. It develops when the oro-antral communication fails to close spontaneously, remains patent and becomes epithelialized .

Epidemiology

There is a slightly greater male predilection .

Pathology

Subtypes

Oroantral fistulas may be subtyped by location into:

  • alveolosinusal fistula
  • palatalosinusal fistula
  • vestibulosinusal fistula
Causes

They can result from a number of reasons:

Radiographic features

CT

Typically seen as a disruption or defect involving the bony floor of the maxillary sinus with soft-tissue opacification or fluid involving the ipsilateral sinus.

Treatment and prognosis

Oroantral fistulas <2 mm wide usually heal without intervention, larger fistulas may require surgery .

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