Treatment of oronasal fistula – Gunshot wound sequela: case report

Authors

DOI:

https://doi.org/10.33448/rsd-v9i11.8941

Keywords:

Oronasal fistula; Maxillary sinus; Gunshot wounds.

Abstract

Introduction: Oronasal communications are conditions in which there is direct access to the oral cavity, either through the alveolar ridge or the palate, with the maxillary sinus. When it is covered by epithelial tissue, it is referred to as oronasal fistula. Its etiology can come from extractions, pathologies in the palate, periapex and maxillary sinus, infections, osteonecrosis, and trauma. The signs and symptoms that are observed range from the passage of air and fluids from the nose to the mouth, and vice versa, to acute or chronic sinusitis, with the possibility of being asymptomatic in some cases. Its diagnosis is reached with the physical/clinical examination, associated with imaging tests. Usually, the treatment consists of a surgical approach, which should be performed as soon as possible, and the surgical techniques and types of flaps used vary according to the type of communication. Case report: Patient victim of a gunshot wound for about 04 years, evolving with oronasal communications of dimensions approximately 02cm X 01cm (length X width), reaching the alveolar ridge. The treatment performed was through surgery to correct/close oronasal communications in a hospital environment with the association of three techniques. Discussion: The surgical techniques used to close communications and oronasal fistulas are basically the three most used, each presenting advantages and disadvantages, as well as the best indication for each case. The Bichat's ball is considered the most used technique, presenting as a disadvantage, the possible reduction of the vestibule bottom, thus hindering posterior prosthetic rehabilitation, such as the vestibular flap. Palatal flaps are more indicated when communications are more extensive, their disadvantages include the raw area exposed on the palate when the flap needs to be rotated. Conclusion: The case report differs from the others found in the current literature due to the association of surgical techniques used to close buccal sinus fistulas, and the benefits that the association of these brought to the patient.

References

Abuabara, A., Cortez, A. L. V., Passeri, L. A., de Moraes, M., & Moreira, R. W. F. (2006). Evaluation of different treatments for oroantral/oronasal communications: experience of 112 cases. International Journal of Oral and Maxillofacial Surgery, 35(2), 155–158. https://doi:10.1016/j.ijom.2005.04.024.

Andrade de Souza, K. S., Milani, C. M., Thomé, C. A. (2014). Surgical treatment of a large oroantral fistula: Case report. Odonto; 22(43-44), 93-100.

Bittencourt, K. P., & Pereira, J. C. (2017). Comunicação Buco Sinusal Diagnóstico e Tratamento: Uma Revisão Da Literatura. Trabalho de Conclusão de Curso para obtenção do grau em odontologia. Curso de Odontologia da Universidade Tiradentes. Aracaju – SE, maio.

Caetano, R. M., Jogaib, J. C., Netto, A. G., Oliveira, C. D., Junqueira, J. L. C., & Buscatti, M. Y. (2011). Avaliação da presença de extensões anteriores dos seios maxilares por meio de tomografia computadorizada por feixe cônico. Cadernos UniFOA. Volta Redonda, Ano VI, n. 17.

igueiredo Filho, A. O., Aguiar, P. L., Santana, B. de M., Nogueira, E. F. de C., Araújo, F. A da C., & Vasconcellos, R. J de H. (2020). Opções cirúrgicas no tratamento da fístula oroantral / comunicação: Série de casos. Research, Society and Development , 9 (10), e6139109039. https://doi.org/10.33448/rsd-v9i10.9039

Freitas, T. M. C., Farias, J. G., Mendonça, R. G., Alves, M. F., Ramos, R. P., & Câncio, A. V. (2003). Oroantral fistulas: diagnosis and management purposes – Case report. Rev Bras Otorrinolaringol. 69(6), 838-44.

Gusman, D. J. R., Passos, J. P. T., Araújo, N. J., Novaes, V. C. N., Bertão, J. M., Macarini, V. C., & Almeida, J. M. (2017). Fechamento de Fístula Bucoantral: Relato de Caso Clínico. Revista Funec Científica – Odontologia. 1(1), 33-45.

Macedo, R. A. de P., Pereira, V. B. S., Barros, A. V. M., Rodrigues, É. D. R., Santos, K. R., Vasconcelos, B. C. do E., & Barbirato, D. S. (2020). Fechamento cirúrgico da comunicação oroantral com L-PRF: relato de caso. Research, Society and Development, 9 (10), e2359108502. https://doi.org/10.33448/rsd-v9i10.8502.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. Santa Maria, RS:UFSM, NTE.

Poeschl, P. W., Baumann, A., Russmueller, G., Poeschl, E., Klug, C., & Ewers, R. (2009). Closure of Oroantral Communications With Bichat’s Buccal Fat Pad. Journal of Oral and Maxillofacial Surgery, 67(7), 1460–1466. doi:10.1016/j.joms.2009.03.049.

Rocha, C. B. S., Cavalcante, M. B., Uchôa, C. P., Silva, E. D. O., Marcelina, I. M. P. (2020). Bichat ball for the treatment of buco-sinusal fistula: case report. Rev. Cir. Traumatol. Buco-Maxilo-Fac., Camaragibe 20(1), 34-38.

Tucunduva, M. J. A. P. S., Bolzan, J. D., Ferreira, T. L. D., Baladi, M. G., & Freitas, C. F. (2013). Variações da anatomia da cavidade nasal e dos seios paranasais - relato de caso. Rev. Odontol. Univ. Cid. São Paulo, 25(1), 83-7.

Veras Filho, R. O., Giovanella, F., Karsburg, R. M., & Torriani, A. M. (2010). Oroantral communication closure using a pedicled buccal fat pad graft – Case Report. Rev. odonto ciênc. 25(1), 100-103.

Visscher, S. H., van Minnen, B., & Bos, R. R. M. (2010). Closure of Oroantral Communications Using Biodegradable Polyurethane Foam: A Feasibility Study. Journal of Oral and Maxillofacial Surgery, 68(2), 281–286. doi:10.1016/j.joms.2009.07.019.

Yalçın, S., Öncü, B., Emes, Y., Atalay, B., & Aktaş, İ. (2011). Surgical Treatment of Oroantral Fistulas: A Clinical Study of 23 Cases. Journal of Oral and Maxillofacial Surgery, 69(2), 333–339. doi:10.1016/j.joms.2010.02.061.

Published

17/11/2020

How to Cite

Fernandes, A. C. F., Griza, G. L. ., Garbin Junior, E. Álvaro, Ernica, N. M. ., Conci, R. A., & Araújo, M. C. . (2020). Treatment of oronasal fistula – Gunshot wound sequela: case report. Research, Society and Development, 9(11), e3519118941. https://doi.org/10.33448/rsd-v9i11.8941

Issue

Section

Health Sciences