To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter<7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter<15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter<25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.
Fistula/surgery* ; Humans ; Inflammation ; Maxilla ; Maxillary Sinus/surgery* ; Oroantral Fistula/surgery*

Surgery, Pusan National University Hospital from 2003 to 2005, we have reviewed the clinical data of the patients and analysed. The results were as follows:1. Tongue flaps have been mainly applied on anterior portion of palate and maxilla. The survival rate was high percent, but the cooperation of patient was inevitable for the success.2. Palatal mucosa rotational flaps were available on relative large defect on palate, oroantral fistula site. The side effect was a scaring band from secondary healing on denuded donor palate site. Sometimes the band came to be a hinderance to swallowing, phonation.3. Forearm free flap was a workhorse flap for everywhere in intraoral defects. We had used the flap on cheek, floor of mouth, tongue without any significant complications. But the application of the flap was required for long operation time, which was disadvantageous to the old, weak patients.4. Cervical platysmal flap could be easily applicable for buccal cheek, floor of mouth after excision of the cancer lesion. The design of the flap could be made simultaneously on neck dissection, but the danger of cancer remnants on the flap always might be remained.5. Buccal fat pad pedicled flap must have been a primary flap for repair of oroantral fistula especially on posterior maxilla.The flap survival will be expected if the considerations for above reconstructive methods on site, size, condition of defects primarily could be made.]]>
Adipose Tissue ; Busan ; Cheek ; Deglutition ; Forearm ; Free Tissue Flaps ; Humans ; Maxilla ; Mouth Floor ; Mucous Membrane ; Neck Dissection ; Oroantral Fistula ; Palate ; Phonation ; Prognosis ; Surgery, Oral ; Surgical Flaps ; Survival Rate ; Tissue Donors ; Tongue