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<p>Oroantral fistulas (OAF) are abnormal epithelialized tracts connecting maxillary sinus to oral cavity and are commonly associated with maxillary tooth extractions. We should do a thorough preoperative assessment to successfully repair fistulas&#xa0;to predict surgical outcomes. This study proposes to develop and validate a preoperative CT scoring system using several radiological parameters to predict the success rate of OAF repair. Fifty patients with chronic OAF secondary to traumatic maxillary tooth extraction were&#xa0;included in a&#xa0;prospective observational case series study. A suggested CT scoring system was introduced, to evaluate six parameters:&#xa0;size of the fistula,&#xa0;presence of edge osteitis, maxillary mucosal pathology, status of the osteomeatal complex, volume of the maxillary sinus, and&#xa0;thickness of the sinus floor. A cutoff score of ≥ 7 showed high sensitivity (100%), specificity (93.2%), and overall accuracy (96%) in predicting surgical failure of OAF repair. Larger fistula size, edge osteitis, maxillary mucosal pathology, and a closed osteomeatal complex were significantly associated with lower repair success rates. Volume of the maxillary sinus and thickness of the sinus floor had less effect on repair outcomes. This preoperative CT scoring system aids preoperative assessment, surgical planning, predicting the success of OAF repair, and improving patient outcomes.</p>

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Proposal of a Preoperative Radiological Score as a Predictive Tool in Oroantral Fistula Surgical Repair Success Rate

  • 期刊论文

  • 发表日期：

    2025年6月18日

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  • Saad Elzayat,
  • Mohamed Mohamed Hussein,
  • Ahmed Ebeed,
  • Haitham H. Elfarargy,
  • Sobhy Khaled

摘要

Oroantral fistulas (OAF) are abnormal epithelialized tracts connecting maxillary sinus to oral cavity and are commonly associated with maxillary tooth extractions. We should do a thorough preoperative assessment to successfully repair fistulas to predict surgical outcomes. This study proposes to develop and validate a preoperative CT scoring system using several radiological parameters to predict the success rate of OAF repair. Fifty patients with chronic OAF secondary to traumatic maxillary tooth extraction were included in a prospective observational case series study. A suggested CT scoring system was introduced, to evaluate six parameters: size of the fistula, presence of edge osteitis, maxillary mucosal pathology, status of the osteomeatal complex, volume of the maxillary sinus, and thickness of the sinus floor. A cutoff score of ≥ 7 showed high sensitivity (100%), specificity (93.2%), and overall accuracy (96%) in predicting surgical failure of OAF repair. Larger fistula size, edge osteitis, maxillary mucosal pathology, and a closed osteomeatal complex were significantly associated with lower repair success rates. Volume of the maxillary sinus and thickness of the sinus floor had less effect on repair outcomes. This preoperative CT scoring system aids preoperative assessment, surgical planning, predicting the success of OAF repair, and improving patient outcomes.