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Suggest Treatment For Oro-antral Fistula

Posted on Thu, 20 Aug 2015

Question: hello doctor..thankyou for answering my previous queries..it has been really helpfull..just to let u know once again i underwent torus palatinus surgery on march and after like two months a fistula has developed..the hole is not very big but big enough for food particles to pass through the nose...i have sent a recent picture of the fistula below..kindly tell me if the fistula need a surgery or should i wait for sometime for it to heal...somtimes i feel my speech is not clear due to air passing through the fistula and i have to give effort..there is also a constant oozing of water through nose as if i have catch cold..and it is really embarrasing at times..i have to sit straight to drink and eat so that the food doesnt come out through nose and i have almost given up eating spicy food as it hurt while eating.my wound has not completely healed and my doctor told me to give it some time to heal and also said that fistula will heal on its own but m not very satisfied so just for self satisfaction i want to know that will fistula heal on its own and how long i might have to wait and lastly what are the precaution i must take to not let fistula grow..thankyou

Answered by Dr. Sumit Bhatti (2 hours later)

Brief Answer:
Oro- antral fistula usually do not heal. Wait XXXXXXX 4-6 weeks.

Detailed Answer:
Hi,

Thank you for your query.

1. Since the fistula has formed after two months, it is a breakdown of the operative wound.

2. It is unlikely to heal unless you use an obturator to protect the palate.

3. There is always a possibility of closure on it own. That should not take more than 4-6 weeks.

4. The obturator and a soft diet will prevent further increase in the size of the fistula.

5. It can be closed by a rotation plate flap surgery.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sumit Bhatti (3 hours later)

that means there is no chance of self healling of fistula on its own if given enough time? and does the surgery of fistula confirms that it will close permanently? is there any chance of recurrence even after the surgery?..sir i am trying to eat from the opposite site of the fistula as much as possible but little mount of food particles always manages to get trapped in fistula..will that cause the fistula to grow in size?

Answered by Dr. Sumit Bhatti (4 hours later)

Brief Answer:
These are difficult to predict.

Detailed Answer:
Hi,

Thank you for writing back.

1. These are difficult to predict.

2. A late oro antral fistula is unlikely to close on its own after 4-6 weeks.

3. Surgery with a rotation flap should be successful, however the bone will be missing.

4. Trauma or rough foodstuff may damage the palate again and lead to a recurrence.You will have to be careful.

5. It is better to get this treated when there is no infection. The image shows congestion and redness. Start medication first. Review in a few weeks and decide.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar