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Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy

Published online by Cambridge University Press:  06 May 2016

A K Mishra ,
V R Sinha ,
A Nilakantan  and
D K Singh
A K Mishra*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
V R Sinha
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
A Nilakantan
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
D K Singh
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research and Referral), Delhi, India
*
Address for correspondence: Col Awadhesh Kumar Mishra, Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research & Referral), Delhi Cantt, Delhi – 110010, India Fax: +91 11 256 98691 E-mail: buddhiprakash@rediffmail.com
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Abstract

Objective:

A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated.

Methods:

Twenty-six consecutive patients (15 males and 11 females) aged 28–72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management.

Results:

At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund–Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups.

Conclusion:

Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.

Keywords

SinusitisOroantral FistulaTooth ExtractionAntibiotics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 6 , June 2016 , pp. 545 - 553
Copyright
Copyright © JLO (1984) Limited 2016 

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