Cases reported "Oral Fistula"

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1/32. Spontaneous palatal fenestration: review of the literature and report of a case.

    A 42-year-old, edentulous man presented with a defect in his hard palate. He gave a history of a painless lump one year previously which had discharged after a week. Investigations showed only long-standing hypoplasia of the left palatine process, with no evidence of any destructive process. We assumed that the fistula had developed as a result of breakdown of the mucosa covering an isolated cleft of the hard palate. We offered him repair, but he preferred to rely on his maxillary complete denture to cover the defect, and this has worked.
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ranking = 1
keywords = fistula
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2/32. Rare case of naso-oral fistula with extensive osteocartilaginous necrosis secondary to cocaine abuse: review of otorhinolaryngological presentations in cocaine addicts.

    We report what we believe to be only the 10th case of palatal necrosis secondary to cocaine abuse in a 33-year-old female patient. Extensive necrosis also involved the cartilaginous and bony septum and paranasal sinuses. Following exclusion of other mid-line destructive diseases her treatment involved saline douches and cessation of cocaine. She remains under review within the department with no evidence of progressive disease. We present a review of the other nine cases of palatal necrosis reported in the world literature and demonstrate a greater incidence in female users. The various presenting conditions of cocaine abuse encountered within the head and neck region by the otorhinolaryngologist are then discussed.
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ranking = 4
keywords = fistula
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3/32. The sandwich technique for closure of a palatal fistula.

    A full-thickness fistula of the hard palate can be closed by various methods. Recurrences are seen many times and more stable methods of closure have been researched. The authors attempted to close a palatal fistula by adhering to the main rule of reconstruction as stated by Gillies, "replace the lost tissues in kind." They used a buccinator musculomucosal transposition flap for the nasal lining, a cranial bone graft for the palatal bone, and a local mucoperiosteal transposition flap for the oral closure. The flaps and bone adapted well to the fistula. There were no recurrences during 12 months of follow-up. This "sandwich flap"--a three-layer closure--is a reliable technique for the repair of a full-thickness palatal fistula.
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ranking = 8
keywords = fistula
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4/32. Oronasal fistula repair with three layers.

    We present an innovative method for closure of oronasal fistulas involving a three-layer repair, consisting of septal mucosa flap, bone or cartilage graft, and palatal mucosa flap. The septal mucosa flap closes the nasal side of the defect. This is an inferiorly based flap along the nasal floor and consists of septal mucosa from the side opposite the oronasal fistula. A slit is created in the remaining layers of the nasal septum, allowing the flap to be delivered into the defect. When the septal flap is folded down in this fashion, it exposes nasal septal bone and cartilage. The bone and cartilage are harvested and are used to create the middle layer of the three-layer fistula repair. The oral layer of the repair is provided by a palatal mucosa transposition flap. This method allows the bone/cartilage graft to be sandwiched between two vascular layers. We have successfully used the three-layer repair on three patients. All of the oronasal defects were 2 cm in size. All patients are at least 1 year after repair with 100 percent closure; thus, no oronasal leakage. The flaps both septal and palatal resulted in no morbidity once healed. Specifically, the surgically created slit in the nasal septum is well mucosalized and barely discernible. Also, no nasal obstruction occurs from the septal flap on the floor of the nose. We perform the procedure on an outpatient basis. The three-layer repair can be used in adult patients with oronasal fistulas of the middle and posterior hard palate up to 3 cm in size. This technique is not recommended for children.
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ranking = 8
keywords = fistula
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5/32. The dental management of a patient with a cocaine-induced maxillofacial defect: a case report.

    There are several dental complications associated with cocaine abuse, including adverse reactions to dental anesthetics, post-operative bleeding, and cellulitis, which can lead to necrosis of orbital, nasal, and palatal bones. Following is a report of the initial treatment rendered to a patient who had destroyed most of her hard palate over a ten-year period of cocaine abuse. There are no classic socio-economic or educational profiles for abusers of cocaine. Drug abuse victims may present as patients in any dental office. Though there are certain classic physiological and psychological symptoms of their condition, they may not display symptoms at all.
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ranking = 0.010276317876985
keywords = dental
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6/32. Team approach for closure of oroantral and oronasal fistulae.

    Oroantral and oronasal fistulas present with a broad range of causation, size, duration, and extent of infection involving the nose and paranasal sinuses. Accurate diagnosis of the extent of the disease with appropriate radiographic evaluation will guide the surgeon to select an approach that addresses all of the infected sites. When significant sinus disease is found, an endoscopic approach to restoring drainage in all of the involved sinuses can promote predictably successful closure of oroantral and oronasal fistulas. The multispecialty team approach to this disease, with the concomitant management of the sinusitis and fistula closure, is a significant advance in the successful management of this chronic condition.
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ranking = 7
keywords = fistula
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7/32. Modified retrograde intubation in a patient with difficult airway.

    We report a modified technique of retrograde endotracheal intubation in a patient with limited motility at the atlanto-occipital joint, temporomandibular joint, and cervical spine, presenting for closure of a large oronasal fistula. Despite more recent advances in intubation techniques and technology, retrograde intubation still deserves a place in the anesthetist's armamentarium for the management of the difficult airway.
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ranking = 1
keywords = fistula
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8/32. Closure of an oronasal fistula in an irradiated palate by tissue and bone distraction osteogenesis.

    Uses for distraction osteogenesis in the craniofacial skeleton have expanded during the last decade. It has become an important rung in the reconstructive ladder for correction of difficult defects. Distraction of irradiated bone has been successfully performed in an animal model but has not been reported in human subjects. We present a case of distraction osteogenesis in a patient with multiple failed reconstructive attempts to close an irradiated palatal defect. An additional benefit included improvement in support of the upper lip from bone transported and the potential for placing dental implants.
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ranking = 4.001468045411
keywords = fistula, dental
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9/32. Distraction osteogenesis for reconstruction after mandibular segmental resection.

    Distraction osteogenesis with the shortening and lengthening method is a well-established procedure for repairing extremities. We used this technique for reconstruction after mandibular segmental resection. A 74-year-old woman underwent distraction osteogenesis with an intraoral device, initially shortening the mandible after a 20-mm-long segmental resection, followed by lengthening at a rate of 0.8 mm per day for 21 days. Eight weeks after the distraction, the device was removed and a dental implant was placed at the site of distraction. Radiographic observation showed new bone formation, and the implant was completely osseointegrated. Although the follow-up period is relatively short, the clinical course was uneventful. Distraction osteogenesis with the shortening and lengthening method seems to be a feasible option for reconstruction after segmental resection of the mandible.
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ranking = 0.0014680454109979
keywords = dental
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10/32. Simultaneous cortex bone plate graft with particulate marrow and cancellous bone for reliable closure of palatal fistulae associated with cleft deformities.

    OBJECTIVE: The purpose of this study was to evaluate the effectiveness of simultaneous cortex bone plate (CBP) graft with particulate marrow and cancellous bone (PMCB) graft for reliable closure of palatal fistulae associated with alveolar clefts. DESIGN: Following standard secondary bone graft preparation of the cleft site, CBP harvested from the medial iliac crest was inserted into the palatal deficiency. This was followed by suturing the palatal mucosa. PMCB was then packed between the cortical bone and the reconstructed nasal floor. SETTING: Ten consecutive patients with palatal fistula were operated on at tokyo Medical and Dental University Hospital from 1998 to 2000. Primary palatal repair was performed in 7 out of 10 patients at our center and in 3 out of 10 patients at other hospitals. patients: Ten patients (6 boys and men, 4 girls and women) with a palatal fistula associated with an alveolar cleft were studied. Ages ranged from 12 to 26 years. INTERVENTIONS: All patients underwent simultaneous CBP graft with PMCB graft for closure of palatal fistula under general anesthesia. RESULTS: Complete closure of palatal fistulae were obtained in 8 out of 10 cases. A very small asymptomatic fistula remained in one patient. Total necrosis of the labial flap with a residual palatal fistula occurred in one patient. CONCLUSIONS: Simultaneous CBP graft with PMCB graft could be more reliable than PMCB alone for closure of a cleft associated palatal fistula.
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ranking = 12
keywords = fistula
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