Oral and Maxillofacial Surgery Unit, Shaare Zedek Medical Center, P.O.B 3235, 9103102 Jerusalem, Israel.
Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, 49100 Petach-Tikva, Israel.
Medicina (Kaunas). 2020 Jun 23;56(6):310. doi: 10.3390/medicina56060310.
: Smoking has been found to interfere with wound healing processes. Therefore, the purpose of this study was to compare surgical treatment of oroantral fistulae (OAFs) in smokers and non-smokers. Medical records of all consecutive patients who underwent surgical closure of OAFs between 2003 and 2016 at the oral and maxillofacial surgery department, Rabin Medical Center, Israel were reviewed. Patients' demographic data, preoperative signs and symptoms, surgical method of repair, and postoperative complications were recorded. The cohort consisted of 38 smokers and 59 non-smokers. Age and gender distributions were similar in both groups. The main etiology in both groups was tooth extraction, followed by pre-prosthetic surgery in smokers and odontogenic infection in non-smokers ( = 0.02). Preoperative conditions were not significantly different between smokers and non-smokers in terms of size of soft tissue fistula and bony defect, chronic sinusitis and foreign bodies inside the sinus. OAFs were repaired by local soft tissue flaps without consideration of smoking status. Smokers experienced more moderate-severe postoperative pain ( = 0.05) and requested more weak opioids ( = 0.06). Postoperative complications included infection, delayed wound healing, residual OAF, pain, sensory disturbances and sino nasal symptoms. These were mostly minor and tended to be more frequent in smokers ( = 0.35). Successful closure of OAFs was obtained in all patients except one smoker who required revision surgery. Smokers may be more susceptible to OAFs secondary to preprosthetic surgery. In this cohort, there was no statistically significant difference in outcome between smokers and non-smokers in terms of failure. However, smokers tended to have more severe postoperative pain and discomfort and to experience more postoperative complications. Further studies with larger sample sizes should be conducted to validate these results.
吸烟已被发现会干扰伤口愈合过程。因此，本研究的目的是比较吸烟者和非吸烟者的口腔上颌窦瘘（OAF）的手术治疗。
回顾了 2003 年至 2016 年间在以色列拉宾医疗中心口腔颌面外科接受 OAF 手术闭合的所有连续患者的病历。记录了患者的人口统计学数据、术前症状和体征、修复的手术方法以及术后并发症。
该队列包括 38 名吸烟者和 59 名非吸烟者。两组的年龄和性别分布相似。两组的主要病因都是拔牙，其次是吸烟者的术前手术和非吸烟者的牙源性感染（= 0.02）。吸烟者和非吸烟者的软组织瘘和骨缺损大小、慢性鼻窦炎和窦内异物等术前情况无显著差异。OAF 采用局部软组织瓣修复，不考虑吸烟状况。吸烟者经历了更严重的中度术后疼痛（= 0.05），并要求更多的弱阿片类药物（= 0.06）。术后并发症包括感染、伤口愈合延迟、残留 OAF、疼痛、感觉障碍和鼻窦症状。这些大多是轻微的，且在吸烟者中更为常见（= 0.35）。除了一名需要再次手术的吸烟者外，所有患者均成功闭合了 OAF。
吸烟者可能更容易发生与术前手术相关的 OAF。在本队列中，吸烟者和非吸烟者在失败方面的结果无统计学差异。然而，吸烟者术后疼痛和不适更严重，且术后并发症更多。应进行更大样本量的进一步研究来验证这些结果。
