Clinical and radiographic assessment and restoration of maxillary sinus function in relation to oro-antral fistula closure: a systematic review

Garmon Bell (Lead / Corresponding author), Laura Howard, Thomas Lamont

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: The purpose of this study was to determine current practice in assessment of maxillary sinus health during oro-antral fistula closure.

Method: A systematic review using specific MeSH headings between 1990 and September 2021 on Medline, Ovid, and PubMed was performed. The inclusion criterion was closure of oro-antral fistula in adult patients. Exclusion criteria were oro-antral fistula arising in children; or from trauma, malignancy, or developmental abnormality; or any osteonecrotic lesion of bone. Risk of bias for individual papers was not assessed. Oxford Centre for Evidence Based Medicine levels of evidence were recorded.

Results: 4309 papers were identified, and 119 were eligible for review. Nineteen were from otolaryngology (16%), 25 from combined ear, nose, and throat (ENT) and oral/oral and maxillofacial (OS/OMF) surgery (21%), and 75 from OS/OMF surgery (63%). Preoperative rhinoscopy and cross-sectional imaging were reported in 33 papers (28%), reflecting the role of ENT with or without OS/OMFS. Sixty-eight did not record any formal assessment of maxillary sinus health (57%), of which 60 were from OS/OMF surgery (50%). Use of computed tomography was reported in 58 papers (49%), and use of cone beam computed tomography was reported in 8 papers (7%) but did not correlate with assessment of sinus health.

Discussion: Most surgery for oro-antral fistual closure was undertaken without objective assessment of maxillary sinus health, pre- or postoperatively. The involvement of ENT was associated with formal assessment of maxillary sinus health.

Original languageEnglish
Pages (from-to)432-441
Number of pages10
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Volume134
Issue number4
Early online date3 Mar 2022
DOIs
Publication statusPublished - Oct 2022

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