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Closure of Oroantral Fistula With Buccal Fat Pad Flap and Endoscopic Drainage of the Maxillary Sinus

Abdel-Aziz, Mosaad, MD*; Fawaz, Mohamed, MD; Kamel, Mohamed, MD; Kamel, Ahmed, MD; Aljeraisi, Talal, MD§

doi: 10.1097/SCS.0000000000004709
Clinical Studies

Oroantral fistula (OAF) is a pathologic communication between the oral cavity and the maxillary sinus. It is usually associated with maxillary sinusitis, where drainage of sinus infection is a mandatory step during closure of the fistula. The flap used for closure of OAF should be tension free, broadly based and well vascularized. The aim of this study was to assess the effectiveness of closure of OAF using buccal fat pad (BFP) flap with concomitant endoscopic middle meatal antrostomy for maxillary sinus drainage. Nineteen patients with chronic OAF were included in the study. Closure was performed using BFP with endoscopic middle meatal antrostomy. Preoperative and postoperative assessments were carried out. Patients were followed up for at least 1 year postoperatively. Complete closure of all OAFs was achieved with no recurrence or dehiscence. In conclusion, closure of OAF with BFP flap and concomitant endoscopic drainage of the maxillary sinus through the middle meatus is an effective, easy, and simple method. It has a high success rate with no effect on the vestibular depth or mouth opening.

*Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo

Department of Otolaryngology, Faculty of Medicine, Beni Suef University, Beni Suef

Department of Otolaryngology, Faculty of Medicine, Fayoum University, Fayoum, Egypt

§Department of Otolaryngology, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia.

Address correspondence and reprint requests to Mosaad Abdel-Aziz, MD, 2 El-Salam Street, King Faisal, Above El-Baraka Bank, Giza, Cairo, Egypt; E-mail: and

Received 18 January, 2018

Accepted 10 May, 2018

The study was conducted as a multicenter study on the Departments of Otolaryngology of Cairo University, Beni Suef University, Fayoum University (Egypt) and Taibah University (Saudi Arabia). It was conducted in the period from March 2015 to November 2017.

The authors report no conflicts of interest.

© 2018 by Mutaz B. Habal, MD.