Citation, DOI, disclosures and article data
Citation:
Bickle I, Weerakkody Y, Foster T, et al. Oroantral fistula. Reference article, Radiopaedia.org (Accessed on 26 Mar 2025) https://doi.org/10.53347/rID-25277
Oroantral fistulas are a pathological communication between the oral cavity and the maxillary sinus (antrum).
The term oroantral fistula is similar to but not synonymous with the term oroantral communication (OAC). An oro-antral fistula refers to an "epithelialised" pathological unnatural communication between the oral cavity and the maxillary sinus. It develops when the oro-antral communication fails to close spontaneously, remains patent and becomes epithelialised 6.
There is a slightly greater male predilection 2.
Subtypes
Oroantral fistulas may be subtyped by location into:
Causes
They can result from a number of reasons:
CT
Typically seen as a disruption or defect involving the bony floor of the maxillary sinus with soft-tissue opacification or fluid involving the ipsilateral sinus.
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Treatment and prognosis
Oroantral fistulas <2 mm wide usually heal without intervention, larger fistulas may require surgery 7.
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1. Abrahams JJ, Berger SB. Oral-maxillary sinus fistula (oroantral fistula): clinical features and findings on multiplanar CT. AJR Am J Roentgenol. 1995;165 (5): 1273-6. doi:10.2214/ajr.165.5.7572517 - Pubmed citation
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2. Borgonovo AE, Berardinelli FV, Favale M et-al. Surgical options in oroantral fistula treatment. Open Dent J. 2012;6 (1): 94-8. doi:10.2174/1874210601206010094 - Free text at pubmed - Pubmed citation
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3. Steinklein J, Nguyen V. Dental Anatomy and Pathology Encountered on Routine CT of the Head and Neck. AJR Am J Roentgenol. 2013;201 (6): W843-53. doi:10.2214/AJR.12.9616 - Pubmed citation
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4. Abrahams JJ. Dental CT imaging: a look at the jaw. Radiology. 2001;219 (2): 334-45. doi:10.1148/radiology.219.2.r01ma33334 - Pubmed citation
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5. Steinklein J, Nguyen V. Dental Anatomy and Pathology Encountered on Routine CT of the Head and Neck. AJR Am J Roentgenol. 2013;201 (6): W843-53. doi:10.2214/AJR.12.9616 - Pubmed citation
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6. Khandelwal P, Hajira N. Management of Oro-antral Communication and Fistula: Various Surgical Options. (2017) World journal of plastic surgery. 6 (1): 3-8. Pubmed
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7. Rafael M. Loureiro, Erica A. Naves, Rafael F. Zanello, Daniel V. Sumi, Regina L. E. Gomes, Mauro M. Daniel. Dental Emergencies: A Practical Guide. (2019) RadioGraphics. 39 (6): 1782-1795. doi:10.1148/rg.2019190019 - Pubmed
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8. Manuel S. OroAntral Communications and OroAntral Fistula. Oral and Maxillofacial Surgery for the Clinician. 2021;:491-512. doi:10.1007/978-981-15-1346-6_24
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