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Treatment of Oroantral Fistula in Pediatric Patient using Buccal Fat Pad.

Agrawal A, Singhal R, Kumar P, Singh V, Bhagol A - Int J Clin Pediatr Dent (2015)

Bottom Line: The preferred technique may vary from one surgeon to another.How to cite this article: Agrawal A, Singhal R, Kumar P, Singh V, Bhagol A.Int J Clin Pediatr Dent 2015;8(2):138-140.

View Article: PubMed Central - PubMed

Affiliation: Postgraduate Student, Department of Oral and Maxillofacial Surgery, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India.

ABSTRACT

Unlabelled: Brief background: Oroantral communication (OAC) is the space created between the maxillary sinus and the oral cavity, which, if not treated, will progress to oroantral fistula (OAF). Several methods of surgical OAC repair have been described, but only a few have gained recognition.

Materials and methods: A 13 years old male child patient with complaint of difficulty in drinking water and change in voice diagnosed as OAF managed with closure with buccal fat pad (BFP).

Discussion: Oroantral fistula is an abnormal communication resulting most frequently from extraction of the upper posterior teeth. Many techniques have been proposed for the closure. The preferred technique may vary from one surgeon to another.

Conclusion: The adequate availability of BFP in children, effortless mobilization excellent blood supply and minimal donor site morbidity make it a perfect flap for OAF closure in pediatric patient. How to cite this article: Agrawal A, Singhal R, Kumar P, Singh V, Bhagol A. Treatment of Oroantral Fistula in Pediatric Patient using Buccal Fat Pad. Int J Clin Pediatr Dent 2015;8(2):138-140.

No MeSH data available.


Related in: MedlinePlus

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Figure 3: Exposure of the defect

Mentions: Management: His maxillary antrum was irrigated with normal saline three times within a week. After taking informed written consent for the surgery and getting necessary blood investigations, closure with BFP under local anesthesia was planned. Right posterior superior alveolar nerve block and greater palatine nerve block was given with 2% lignocaine with 1:200000 adrenaline along with the right buccal vestibule infiltration. The mucoperiosteal flap was raised from mesial to 15 to distal to 17 with molt’s periosteal elevator after giving incision with no. 15 blade. The defect (Fig. 3) was curetted with the help of Lucas curette. A incision was given over the periosteum on the undersurface of the flap and with pressure applied to the zygomatic arch region, the BFP easily extruded into the operative side. Dissection with a Metzenbaum scissors helped to mobilize as much BFP (Fig. 4) as needed to obtain a tension-free closure across the communication. The palatal mucosa margin was freshened. The fat pad was then sutured with resorbable suture to palatal mucosa. The buccal flap was then positioned over the BFP and was sutured to palatal mucosa with 3-0 silk suture (Fig. 5). Antibiotics and analgesics were prescribed for 5 days. Patient was advised soft diet and to maintain oral hygiene. Sutures were removed after 2 weeks. The postoperative period was uneventful (Fig. 6).


Treatment of Oroantral Fistula in Pediatric Patient using Buccal Fat Pad.

Agrawal A, Singhal R, Kumar P, Singh V, Bhagol A - Int J Clin Pediatr Dent (2015)

Exposure of the defect
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562048&req=5

Figure 3: Exposure of the defect
Mentions: Management: His maxillary antrum was irrigated with normal saline three times within a week. After taking informed written consent for the surgery and getting necessary blood investigations, closure with BFP under local anesthesia was planned. Right posterior superior alveolar nerve block and greater palatine nerve block was given with 2% lignocaine with 1:200000 adrenaline along with the right buccal vestibule infiltration. The mucoperiosteal flap was raised from mesial to 15 to distal to 17 with molt’s periosteal elevator after giving incision with no. 15 blade. The defect (Fig. 3) was curetted with the help of Lucas curette. A incision was given over the periosteum on the undersurface of the flap and with pressure applied to the zygomatic arch region, the BFP easily extruded into the operative side. Dissection with a Metzenbaum scissors helped to mobilize as much BFP (Fig. 4) as needed to obtain a tension-free closure across the communication. The palatal mucosa margin was freshened. The fat pad was then sutured with resorbable suture to palatal mucosa. The buccal flap was then positioned over the BFP and was sutured to palatal mucosa with 3-0 silk suture (Fig. 5). Antibiotics and analgesics were prescribed for 5 days. Patient was advised soft diet and to maintain oral hygiene. Sutures were removed after 2 weeks. The postoperative period was uneventful (Fig. 6).

Bottom Line: The preferred technique may vary from one surgeon to another.How to cite this article: Agrawal A, Singhal R, Kumar P, Singh V, Bhagol A.Int J Clin Pediatr Dent 2015;8(2):138-140.

View Article: PubMed Central - PubMed

Affiliation: Postgraduate Student, Department of Oral and Maxillofacial Surgery, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India.

ABSTRACT

Unlabelled: Brief background: Oroantral communication (OAC) is the space created between the maxillary sinus and the oral cavity, which, if not treated, will progress to oroantral fistula (OAF). Several methods of surgical OAC repair have been described, but only a few have gained recognition.

Materials and methods: A 13 years old male child patient with complaint of difficulty in drinking water and change in voice diagnosed as OAF managed with closure with buccal fat pad (BFP).

Discussion: Oroantral fistula is an abnormal communication resulting most frequently from extraction of the upper posterior teeth. Many techniques have been proposed for the closure. The preferred technique may vary from one surgeon to another.

Conclusion: The adequate availability of BFP in children, effortless mobilization excellent blood supply and minimal donor site morbidity make it a perfect flap for OAF closure in pediatric patient. How to cite this article: Agrawal A, Singhal R, Kumar P, Singh V, Bhagol A. Treatment of Oroantral Fistula in Pediatric Patient using Buccal Fat Pad. Int J Clin Pediatr Dent 2015;8(2):138-140.

No MeSH data available.


Related in: MedlinePlus