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Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy

  • A K Mishra (a1), V R Sinha (a1), A Nilakantan (a1) and D K Singh (a1)

A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated.


Twenty-six consecutive patients (15 males and 11 females) aged 28–72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management.


At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund–Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups.


Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.

Corresponding author
Address for correspondence: Col Awadhesh Kumar Mishra, Department of Otorhinolaryngology – Head and Neck Surgery, Army Hospital (Research & Referral), Delhi Cantt, Delhi – 110010, India Fax: +91 11 256 98691 E-mail:
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