Akut ve kronik oroantral açıklıkların cerrahi tedavisi: 33 vakalık klinik çalışma

Oroantralcomunicationsare known as pathological connections occuring between the oralcavity and maxillary sinus. Early treatment of thiscondition prevents the development of sinusitis andfistula, as well as the need for more complexmethods of treating patients and the possibility ofrecurrence. In this study; age, sex, etiologic factors,location of the opening, methods of treatment andearly complications of 33 patients that surgicallytreated in Ondokuz Mayıs University, Faculty ofDentistry, Oral and Maxillofacial Surgery Clinicbetween 2005-2011 were examined. 18 (54.54%) oforoantral openings were treated withbuccaladvancement flap, 4 (12.12%) of them were treatedwith palatal rotational flap, 8 (24.24%) of themwere treated with iodoform gauze pack strip and theremaining 3 (9.09%) cases were treated with buccalfat pad, double-tunnel method and primary closure.In all cases, tooth extraction was the only etiologicfactor. 100% (20/20) success was achieved in allpatients with acute openings, while the rate was77% (13/10) in patients with oroantral fistula.

Oroantral comunications are known as pathological connections occuring between the oral cavity and maxillary sinus. Early treatment of this condition prevents the development of sinusitis and fistula, as well as the need for more complex methods of treating patients and the possibility of recurrence. In this study; age, sex, etiologic factors, location of the opening, methods of treatment and early complications of 33 patients that surgically treated in Ondokuz Mayıs University, Faculty of Dentistry, Oral and Maxillofacial Surgery Clinic between 2005-2011 were examined. 18 (54.54%) of oroantral openings were treated with buccal advancement flap, 4 (12.12%) of them were treated with palatal rotational flap, 8 (24.24%) of them were treated with iodoform gauze pack strip and the remaining 3 (9.09%) cases were treated with buccal fat pad, double-tunnel method and primary closure. In all cases, tooth extraction was the only etiologic factor. 100% (20/20) success was achieved in all patients with acute openings, while the rate was 77% (13/10) in patients with oroantral fistula.

 

ÖZET

Oroantral açıklıklar, ağız kavitesi ve maksiller sinüs arasında meydana gelen patolojik bağlantı olarak bilinmektedir. Bu durumun erken dönem tedavisi, sinüzit ve fistül gelişimini önlediği gibi, hastaların daha komplike yöntemlerle tedavi gereksinimlerini ve nüks olasılığını da önlemektedir.  Bu çalışmada, 2005-2011 tarihleri arasında Ondokuz Mayıs Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi kliniğinde cerrahi tedavisi gerçekleştirilen akut veya kronik açıklığa sahip 33 hastanın yaş, cinsiyet, etyolojik faktörler, açıklığın lokalizasyonu, gerçekleştirilen tedavi yöntemleri ve erken dönem komplikasyonları incelenmiştir. Oroantral açıklıkların, 18’i (%54,54) bukkal ilerletme flebi, 4’ü (%12,12)  palatal döndürme flebi, 8’i (24,24) gaz iodoform ile kapatma, kalan 3 olgu ise  (%9,09) bukkal yağ yastığı, çift tünel yöntemi ve primer kapatma yöntemi ile tedavi edilmiştir. Bütün olgularda diş çekimi tek etiyolojik faktör olarak bulunmuştur. Akut açıklığa sahip olguların hepsinde  % 100 (20/20) başarı sağlanırken, kronik açıklığa (oroantral fistül) sahip olgularda ise bu oran % 77 (13/10) de kalmıştır.

Anahtar Kelimeler: oroantral açıklık, oroantral fistül, bukkal ilerletme flep, palatal flep.