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

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.

• Authors: A K Mishra, V R Sinha, A Nilakantan, D K Singh
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 130 Issue 6 Pg. 545-53 (Jun 2016) ISSN: 1748-5460 [Electronic] England
• PMID: 27150223 (Publication Type: Journal Article)

Chemical References

• Anesthetics, Local
• Anti-Bacterial Agents
• Imidazoles
• Nasal Decongestants
• Lidocaine
• xylometazoline

Topics

• Administration, Topical
• Adult
• Aged
• Anesthetics, Local (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Chronic Disease
• Female
• Humans
• Imidazoles (therapeutic use)
• Lidocaine (therapeutic use)
• Male
• Middle Aged
• Nasal Decongestants (therapeutic use)
• Oroantral Fistula (complications, diagnostic imaging, drug therapy)
• Postoperative Complications (therapy)
• Rhinitis (diagnostic imaging, drug therapy, etiology)
• Sinusitis (diagnostic imaging, drug therapy, etiology)
• Tomography, X-Ray Computed
• Tooth Extraction