Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy.

OBJECTIVE: A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated. METHODS: Twenty-six consecutive patients (15 males and 11 females) aged 28-72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management. RESULTS: At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund-Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups. CONCLUSION: Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.

Maxillary odontogenic sinusitis, complicated with cerebral abscess--case report.

Maxillary sinus inflammation, when untreated or incorrectly treated, may extend locoregionally, the remaining paranasal sinuses being the first affected anatomical structures. This is why the understanding of the inflammatory pathology of the maxillary sinus, and particularly of the complications it can generate, is extremely important. The purpose of this presentation is to point out that inflammations of the paranasal sinuses are susceptible to develop complications in certain conditions and threaten the patient's life due to the proximity of vital structures. This is the case of a 16 years old male patient who developed a left maxillary and frontal sinusitis, complicated with cerebral abscess. Early detection, multidisciplinary approach and proper indication of surgical treatment, as well as early suspicion of complication, especially in young male adolescents, are extremely important.

Non-surgical management of stage 3 biphosphonate-related oroantral fistula.

We describe the case of a patient with an oroantral fistula that healed successfully after conservative treatment.

Non-surgical management of an oro-antral fistula in a patient with HIV infection.

BACKGROUND: The risk of post-extraction complications is higher in patients who are immunosuppressed compared to other patients with normal immune function. In addition, invasive dental procedures are more likely to have serious complications in these patients. This case report demonstrates an effective non-surgical procedure to treat an oro-antral fistula in an HIV-infected man. METHODS: The oro-antral fistula was de-epithelialized under local anaesthesia and the patient wore a surgical splint continuously, removing it only for cleaning, for an eight week period. Chlorhexidine gel was regularly applied to the fitting surface of the splint and the oro-antral communication. The patient was reviewed on a regular basis. RESULTS: This procedure resulted in resolution of the patient's symptoms within two weeks. Complete healing of the oro-antral fistula was evident following eight weeks of wearing the surgical splint. CONCLUSIONS: This procedure provided an effective method of treating an oro-antral fistula in an immunocompromised patient without causing any detrimental effects to the patient's overall health. Adequate pre-surgical assessment of patients prior to extractions is important in all patients to help prevent the occurrence of such complications.

Análisis de la relación de las piezas dentarias con el piso del seno maxilar y las complicaciones odontológicas consecuentes / Analysis of the relationship between teeth and maxillary sinus floor and the consequent dental complications

Se presentan diferentes complicaciones sinusales secundarias a extracciones, curetajes de quistes o tratamientos de conducto del primer, segundo y tercer molar, su prevención y tratamiento