Surgical Management of Oroantral Fistula: Locoregional Flaps and Evaluation of Closure Outcomes

Aim To evaluate surgical techniques used for oroantral fistula (OAF) repair in an otolaryngology setting and to assess closure success in relation to etiologic, demographic, and operative factors. Methods This retrospective cohort study included patients who underwent surgical repair of OAF at a tertiary otolaryngology unit between 2007 and 2024. Clinical records were reviewed for demographic, etiologic, and operative variables and OAF closure success. A significance threshold of p< .05 was applied for group comparisons. Results Thirty-six patients underwent 40 OAF repair procedures. Odontogenic causes accounted for 77.5% of cases, whereas tumor-related etiologies represented 17.5%. Concomitant maxillary sinusitis treated with simultaneous functional endoscopic sinus surgery (FESS) was present in 42.5% of cases. Overall, successful closure was achieved in 35 of 40 procedures (87.5%), including three of five initial failures after revision surgery. Among procedures using a single flap, buccal advancement and palatal flaps yielded similar success rates (80.0% vs 93.8%; p=.333). Success rates did not differ between single and combined flap techniques (89.3% vs 83.3%; p=1.000), between procedures with and without grafts (90.0% vs 86.7%; p=1.000), or between cases managed with or without FESS (82.4% vs 91.3%; p=.634). Age, sex, and smoking were not associated with closure failure. Conclusion OAF repair in an otolaryngology setting achieved high success rates. When sinus disease is controlled and flap selection is tailored to defect characteristics and patient factors, both buccal and palatal approaches provide reliable closure. These findings support multidisciplinary management and close collaboration between dental clinicians and otolaryngologists.