Oroantral fistula (OAF) is an epithelialised oroantral communication (OAC). OAC refers to an abnormal connection between the oral cavity and antrum (or maxillary sinus). The creation of an OAC is most commonly due to the extraction of a maxillary (upper) tooth (typically a maxillary first molar) closely related to the antral floor (floor of the maxillary sinus). A small OAC (up to 5mm wide) may heal spontaneously but a larger OAC would require surgical closure to prevent the development of persistent OAF and chronic sinusitis. Classification
Signs and symptoms of an OAC/OAF can include the following
When looking in the mouth, a communication in the upper jaw (i.e. a hole) can be seen connecting the mouth to the maxillary sinus. Sometimes this can be the only sign, as pain (+/- other symptoms) is not always present. Symptoms
· Same side nose blockage (unilateral nasal obstruction). When an OAC or OAF is present, the passage to the maxillary sinus can results in infection and inflammation in the maxillary sinus. This subsequently results in mucus build up presenting as a unilateral nasal blockage
· Sinusitis can progress – this can present as a pain in the midface. Pain can be referred to the upper teeth and be mistaken for toothache· Fluid can flow from the mouth through the communication and into the maxillary sinus.
Treatment
Depending on the location and extent of the bleeding, valsalva retinopathy usually resolves within weeks to months, without any complications. Patients are instructed to avoid anticoagulant drugs and physical activities which cause increase in intrathoracic or intra-abdominal pressure. For a speedy recovery, sometimes Nd:YAG laser or argon laser membranotomy may be advised. History
Valsalva retinopathy was first described in 1972 by American ophthalmologist Thomas D. Duane. == References ==