Case of Chronic Maxillary Sinusitis of dental origin and Oro-antral Fistula:

29 year old male patient from Akchamal region of Kargil block presented with a chief complain of pain and heaviness over the left side of face associated with frequent unilateral nasal blockage.

On thorough investigation patient relieved history of extraction in same region 2 years back from a local dentist, since then he develops the condition. Patient also had the history of consultation with ENT specialist several times for the nasal blockage and facial pain for which he was managed time to time, but the recurrence is still present.

On oral examination a small opening was evident on the alveolar ridge region of first molar tooth mesial to second. Valsalva maneuvre test was positive, base on which the tracing of opening was done using a calibrated periodontal probe that confirms the presence of communication between oral cavity and maxillary sinus.

Radiograph (iopar + PA skull view) also confirms the break in continuity of maxillary sinus floor.

On the bases of history, inspection ,palpation, Valsalva maneuvre, and radiograph a diagnosis of Chronic maxillary sinusitis of dental origin and Oro-antral fistula is made.

Most common cause of Oro antral fistula is traumatic extraction of maxillary molar tooth.

Management;-

As the defect was chronic and measured >2mm Sinus lavage followed by surgical repair of Schneiderian membrane + bone graft + coronally advanced or rotated palatal pedicle flap/ Buccal pad of fat.