MCV ENT UPDATE
Update : August - October 2005
CLOSURE OF OROANTRAL FISTULA
Overcoming the great explorer!
Oroantral fistulae is most often due to dental causes and in a significant number of patients extraction of upper molar teeth is the initiating event. ENT surgeons advise extraction of caries tooth before treating maxillary sinusitis. Some dentists are reluctant to extract upper molars when the roots are inside maxillary sinus. The ENT surgeon then has to step in and insisit on dental extraction.For this, one should be confident in closing an oroantral fistula that may arise out of extraction.
We follow a simple technique of closure of oroantral fistula. The fistula is closed at the time of nasal surgery. Two flaps are created on either sideof the fistula and rotated into the fistula and sutured together. Merocel is placed on the sutured site and tied to the adjacent teeth.
This prevents the GREAT EXPLORER of the mouth, the tongue from disturbing the suture site and loosing the ties. Merocel and suture are removed after 15 days.In our experience failure of closure is not due to technical faults but due to loosening of sutures by the tongue tip of the patient. The purpose of Merocel is to prevent the tongue from disturbing the flap sutures.