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An oromaxillary fistula is an abnormal passageway between one of
the sinuses on either side of your nose (maxillary sinuses) and the roof of your
mouth. It may develop as a birth defect (linked with a
as a complication of removing a
tooth, or from infection or trauma. Sometimes the roots of a tooth are so close
to the bone under a maxillary sinus that the bone is damaged when the tooth is
removed. This can open a passage between the mouth and sinus.
Before surgery, you may have an imaging test, such as a
computed tomography (CT) scan, to help the doctor plan
A surgeon may choose one of several techniques to close the
fistula. One of the most common methods is called flap advancement. It involves
cutting a U-shaped flap of skin in the side or roof of the mouth (sometimes
both) and stretching the flap over the fistula. Sometimes a surgeon will place
a piece of medical-grade foil over the opening and then stitch the skin flap
over the foil.
You probably will have
general anesthesia, which means you will be
unconscious during the operation.
Your doctor will prescribe
antibiotics to prevent infection and a decongestant to
keep the sinuses clear. You probably will take these medicines for a week to 10
You will be given a list of precautions to follow to avoid changes
in pressure between the mouth and nasal passages. Be sure to keep your mouth
open when you sneeze. And don't smoke, blow your nose, or suck on items such
as straws, hard candy, or ice.
This surgery is done to close a fistula between a maxillary sinus
and the mouth. A fistula can cause chronic inflammation or infection of the
Most people who have this surgery recover with no problems.
Infection is the main risk of this surgery. You should call your
doctor if you have:
In some cases, a very small fistula may be treated without surgery.
A dentist or oral surgeon may apply gauze or another product over a blood clot
that forms in the hole left by the extracted tooth. The gauze stays in place
for a few days to help the wound heal.
The American Rhinologic Society is an organization for doctors who treat people with diseases of the nose and sinuses. Patients and other interested individuals can use this Web site to find information about diseases of the sinuses and nose. Doctors and other health professionals can use this Web site to learn about all ARS activities, including scientific meetings and abstracts.
The American Academy of Otolaryngology—Head and Neck
Surgery (AAO-HNS) is the world's largest organization of physicians dedicated
to the care of ear, nose, and throat (ENT) disorders. Its Web site includes
information for the general public on ENT disorders.
Other Works Consulted
Tucker MR, Schow SR (2008). Odontogenic diseases of the maxillary
sinus. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 5th ed., pp. 383–395. St. Louis, MO: Mosby Elsevier.
November 7, 2011
Adam Husney, MD - Family Medicine & Donald R. Mintz, MD - Otolaryngology
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