Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Champlion St, Azrite, Alexandria, Egypt.
Otorhinolaryngology and skull base surgery Department, Faculty of Medicine, Alexandria University, Champlion St, Azrite, Alexandria, Egypt.
BMC Oral Health. 2024 Jun 16;24(1):698. doi: 10.1186/s12903-024-04409-0.
Oroantral fistula (OAF) involves pathological, epithelialized, and unnatural communication between the maxillary sinus and oral cavity. Recently, functional endoscopic sinus surgery has provided minimally invasive treatment options with fewer postoperative complications. The aim of the study was to evaluate the one-stage endoscopic middle meatal antrostomy (EMMA) technique with the application of a platelet-rich fibrin membrane (PRF) for OAF closure and maxillary sinusitis relief.
Patients who suffered from OAF with odontogenic sinusitis were included in this study. Complete excision of the epithelial tract and any necrotic tissue was performed with proper curettage. Then, EMMA was performed with simultaneous closure of the OAF by the application of PRF membranes that were fixed by sutures and covered with an acrylic splint. Patients were clinically evaluated for OAF closure, pain level, and symptom relief. Additionally, the size of the bone defect was measured with the aid of computed tomography (CT) preoperatively and after 24 weeks postoperatively.
This study included nine eligible patients with a mean age of 38 years. The data were collected, tabulated, and statistically analyzed. Soft tissue healing and bone formation occurred in all patients who achieved maxillary sinusitis relief without any complications. Additionally, pain was significantly lower on the 7th postoperative day than on the 1st postoperative day, according to the statistical analysis of the results (p < .001).
One-stage EMMA with the application of PRF membranes and acrylic splint represents a reliable alternative technique for OAF closure and maxillary sinusitis relief that is associated with a lower incidence of complications and minimal postoperative pain.
The trial was registered on 28/02/2024, at clinicaltrials.gov (ID: NCT06281873).
口腔上颌窦瘘（OAF）是上颌窦与口腔之间病理性、上皮化和非自然的连通。 最近，功能性内窥镜鼻窦手术为 OAF 闭合和上颌窦炎缓解提供了微创治疗选择，且术后并发症较少。 本研究旨在评估经鼻内镜中鼻道造口术（EMMA）联合富血小板纤维蛋白膜（PRF）在 OAF 闭合和上颌窦炎缓解中的应用。
本研究纳入患有牙源性上颌窦炎的 OAF 患者。 通过适当的刮除术完全切除上皮性管道和任何坏死组织。 然后，通过应用 PRF 膜同时闭合 OAF 来进行 EMMA，PRF 膜用缝线固定并用丙烯酸夹板覆盖。 临床评估 OAF 闭合、疼痛程度和症状缓解情况。 此外，借助术前和术后 24 周的计算机断层扫描（CT）测量骨缺损的大小。
本研究纳入了 9 名年龄均为 38 岁的合格患者。 收集、制表和统计分析数据。 所有患者均实现了上颌窦炎缓解，软组织愈合和骨形成，且无任何并发症。 此外，根据结果的统计学分析，术后第 7 天的疼痛明显低于术后第 1 天（p < 0.001）。
经鼻内镜应用 PRF 膜和丙烯酸夹板行一期 EMMA 是一种可靠的 OAF 闭合和上颌窦炎缓解替代技术，其并发症发生率较低，术后疼痛较轻。
该试验于 2024 年 2 月 28 日在 clinicaltrials.gov 上注册（ID：NCT06281873）。
