Visscher Susan H, van Roon Marije R F, Sluiter Wim J, van Minnen Baucke, Bos Ruud R M
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Oral Maxillofac Surg. 2011 Dec;69(12):2956-61. doi: 10.1016/j.joms.2011.02.102. Epub 2011 Jul 14.
A retrospective cohort study concerning the surgical closure of oroantral communications (OACs) was carried out to facilitate a comparison between treatment outcomes of conventional surgical treatment and new strategies for closure of OACs. Data were statistically analyzed to gather insight into possible predictor variables of recurrent OAC.
A cohort of patients treated for an OAC from 2004 through 2008 was reviewed. Recorded data included patient age and gender, location and duration of OAC, method of removal of the (pre)molar, presence of maxillary sinusitis, disturbed wound healing, and surgical treatment method. Data analysis included descriptive and multivariate logistic regression analyses with recurrence of OAC as the outcome variable.
In total, 308 patients were included in the sample, of which 28 patients (9.1%) required a second intervention to repair an OAC. Of these 28 patients, 4 patients needed a third intervention, making the total number of recurrent OACs 32 (10.4%). In most cases (60.7%), a buccal advancement flap according to the method of Rehrmann was used to close the perforation. Multivariate regression analysis showed a 15 times higher risk of recurrence with maxillary sinusitis at follow-up.
Overall results of the study showed that OACs recur in about 1 of 10 patients and requires a second intervention after surgical closure. New strategies should therefore result in an equal or better treatment outcome to be considered a suitable treatment option. Furthermore, it was demonstrated that the presence of maxillary sinusitis at follow-up is an important determinant of the treatment outcome of OAC repair.
开展一项关于口腔上颌窦瘘（OAC）手术闭合的回顾性队列研究，以比较传统手术治疗与OAC闭合新策略的治疗效果。对数据进行统计分析，以深入了解OAC复发的可能预测变量。
回顾了2004年至2008年期间接受OAC治疗的一组患者。记录的数据包括患者年龄和性别、OAC的位置和持续时间、（前）磨牙的拔除方法、上颌窦炎的存在、伤口愈合不良以及手术治疗方法。数据分析包括以OAC复发为结果变量的描述性和多变量逻辑回归分析。
样本共纳入308例患者，其中28例（9.1%）需要二次干预修复OAC。在这28例患者中，4例需要三次干预，使OAC复发总数为32例（10.4%）。在大多数情况下（60.7%），采用Rehrmann法的颊侧推进瓣关闭穿孔。多变量回归分析显示，随访时上颌窦炎患者复发风险高15倍。
研究总体结果表明，约十分之一的患者OAC会复发，手术闭合后需要二次干预。因此，新策略应产生同等或更好的治疗效果才能被视为合适的治疗选择。此外，研究表明随访时上颌窦炎的存在是OAC修复治疗效果的重要决定因素。
