Journal of Maxillofacial and Oral Surgery

, Volume 15, Issue 3, pp 293–299 | Cite as

Use of Auricular Cartilage for Closure of Oroantral Fistula: A Prospective Clinical Study

  • Hari Ram
  • Hardik Makadia
  • Gagan MehtaEmail author
  • Shadab Mohammad
  • Rakesh Kumar Singh
  • Nimisha Singh
  • Geeta Singh
Research Paper



The term oro-antral fistula is understood to mean of fistular canal covered with epithelia which may or may not be filled with granulation tissue or polyposis of the sinus mucous membrane. With the presence of a fistula the sinus is permanently open, which enables the passage of microbial flora of the oral cavity into the maxillary sinus and the occurrence of inflammation with all possible consequences. Every now and then various researchers have proposed innumerable techniques to treat this defect. Starting from simple tissue flaps to autogenous grafts to alloplastic materials, an array of procedures have been evaluated in literature but the most promising technique still needs to be evaluated. Consequently, after reviewing an array of such procedures, our present study focussed on a new technique for the closer of oro-antral fistulas using autogenous auricular cartilage graft supported by buccal advancement flap.

Material and method

A total of 20 patients of oro-antral fistula were included in the study and after excising the fistular tract a double layer closure was done by placing auricular cartilage over the defect followed by buccal mucoperiosteal flap. The graft was harvested using posterior auricular approach. Assessment of patients was done at the end of 1 week, 3 weeks, 6 weeks, and 3 months.


We found that the autogenous auricular cartilage graft is an effective sealing material in oro-antral fistula closure. We recommend this technique for the defect size ≤10 mm2 in which future dental implant placement is sought as it allows easy sinus lifting procedure.


Oroantral fistula Auricular cartilage graft Buccal advancement flap 


  1. 1.
    Sokler K, Vuksan V, Lauc T (2002) Treatment of oroantral fistula. Acta Stomatol Croat 36(1):135–140Google Scholar
  2. 2.
    Borgonovo AE, Berardinelli FV, Favale M, Maiorana C (2012) Surgical options in oroantral fistula treatment. Open Dent J 6:94–98CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Von Wowern N (1971) Oro-antral communications and displacements of roots into the maxillary sinus: a followup of 231 cases. J Oral Surg 29(9):622–627Google Scholar
  4. 4.
    Punwutikorn J, Waikakul A, Pairuchvej V (1994) Clinically significant oroantral communications—a study of incidence and site. Int J Oral Maxillofac Surg 23:19–21CrossRefPubMedGoogle Scholar
  5. 5.
    Guven O (1998) A clinical study on oroantral fistulae. J Craniomaxillofac Surg 26:267–271CrossRefPubMedGoogle Scholar
  6. 6.
    Lin PT, Bukachaevsky R, Blake M (1991) Management of odontogenic sinusitis with persistent oro-antral fistula. Ear Nose Throat J 70:488–490PubMedGoogle Scholar
  7. 7.
    Hanazawa Y, Itoh K, Mabashi T, Sato K (1995) Closure of oroantral communications using a pedicled buccal fat pad graft. J Oral Maxillofac Surg 53(7):771–776CrossRefPubMedGoogle Scholar
  8. 8.
    Poeschl PW, Baumann A, Russmueller G, Poeschl E, Klug C et al (2009) Closure of oroantral communications with Bichat’s buccal fat pad. J Oral Maxillofac Surg 67:1460–1466CrossRefPubMedGoogle Scholar
  9. 9.
    Lee JJ, Kok SH, Chang HH, Yang PJ, Hahn LJ et al (2002) Repair of oroantral communications in the third molar region by random palatal flap. Int J Oral Maxillofac Surg 31:677–680CrossRefPubMedGoogle Scholar
  10. 10.
    Kitagawa Y, Sano K, Nakamura M, Ogasawara T (2003) Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases. Oral Surg Oral Med Oral Path Oral Radiol Endod 95:409–415CrossRefGoogle Scholar
  11. 11.
    Ogunsalu C (2005) A new surgical management for oro-antral communication. The resorbable guided tissue regeneration membrane—bone substitute sandwich technique. West Indian Med J 54(4):261–263PubMedGoogle Scholar
  12. 12.
    Saleh EA, Issa IA (2013) Closure of large oroantral fistulas using septal cartilage. Otolaryngol Head Neck Surg 148(6):1048–1050CrossRefPubMedGoogle Scholar
  13. 13.
    Berger A (1939) Oroantral openings and their surgical corrections. Arch Otolaryngol 130:400–402CrossRefGoogle Scholar
  14. 14.
    Martensson G (1957) Operative method in fistulas to the maxillary sinus. Acta Otolaryngol 48:253CrossRefPubMedGoogle Scholar
  15. 15.
    Edgerton M, Zoviekian T (1956) Reconstruction of major defects of the palate. Plast Reconstr Surg 17:105–107CrossRefGoogle Scholar
  16. 16.
    Guerrero-Santos J, Altamirano JT (1966) The use of lingual flaps in repair of fistulas of the hard palate. Plast Reconstr Surg 38:123–128CrossRefPubMedGoogle Scholar
  17. 17.
    Isler SC, Demircan S, Cansiz E (2011) Closure of oroantral fistula using auricular cartilage: a new method to repair an oroantral fistula. Br J Oral Maxillofac Surg 49:86–87CrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2015

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial SurgeryKing George’s Medical UniversityLucknowIndia

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