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<p>Chronic oroantral fistulae (OAF) are persistent epithelialized communications between the oral cavity and maxillary sinus requiring surgical intervention. Management of chronic posterior defects with compromised local tissues remains surgically challenging. A 19-year-old female presented with nasal regurgitation of fluids 3 months following enucleation of a maxillary odontogenic keratocyst. Clinical examination revealed a 6–7&#xa0;mm chronic posterior oroantral fistula distal to the maxillary tuberosity associated with reduced vestibular depth. Cone beam computed tomography demonstrated discontinuity of the sinus floor with mucosal thickening. Following excision of the fistulous tract and repair of the antral lining, reconstruction was performed using a combined buccinator myomucosal and buccal fat pad flap in a layered fashion. Postoperative healing was uneventful, with complete resolution of nasal regurgitation and absence of sinus-related symptoms during follow-up. Radiographic evaluation demonstrated resolution of sinus inflammation. The combined buccinator myomucosal–buccal fat pad flap provided stable and tension-free closure in a chronic posterior oroantral fistula with deficient local tissues and may be considered a reliable reconstructive option in selected complex cases.</p>

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“Layered Closure of a Chronic Posterior Oroantral Fistula Using a Buccinator Myomucosal–Buccal Fat Pad Flap: A Case Report”

  • 期刊论文

  • 发表日期：

    2026年7月2日

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  • Manikandhan Ramanathan,
  • Keerthana Ponvel,
  • A. I. Raj,
  • G. Shruthilaya,
  • Abhipsha Tikayat Ray

摘要

Chronic oroantral fistulae (OAF) are persistent epithelialized communications between the oral cavity and maxillary sinus requiring surgical intervention. Management of chronic posterior defects with compromised local tissues remains surgically challenging. A 19-year-old female presented with nasal regurgitation of fluids 3 months following enucleation of a maxillary odontogenic keratocyst. Clinical examination revealed a 6–7 mm chronic posterior oroantral fistula distal to the maxillary tuberosity associated with reduced vestibular depth. Cone beam computed tomography demonstrated discontinuity of the sinus floor with mucosal thickening. Following excision of the fistulous tract and repair of the antral lining, reconstruction was performed using a combined buccinator myomucosal and buccal fat pad flap in a layered fashion. Postoperative healing was uneventful, with complete resolution of nasal regurgitation and absence of sinus-related symptoms during follow-up. Radiographic evaluation demonstrated resolution of sinus inflammation. The combined buccinator myomucosal–buccal fat pad flap provided stable and tension-free closure in a chronic posterior oroantral fistula with deficient local tissues and may be considered a reliable reconstructive option in selected complex cases.