Closure of large oro-antral fistula using autograft septal cartilage: a new technique

Oroantral fistula is a pathologic communication between the oral cavity and the maxillary sinus which usually occurs as a result of maxillary posterior tooth extraction. The aim of the current work is to present a new technique for closure of oroantral fistulas using autogenous septal cartilage and a buccal pyramidal flap. All patients undergoing closure of large oroantral fistula using this technique in Hai Al Jamea Hospital, .Jeddah, Saudi Arabia between the years 2001 and 2005 were included in this study. There were eleven patients, eight of whom had chronic oroantral fistulas. The aetiology was tooth extraction in nine cases [81.8%], primordial maxillary cyst excision in one case [9.1%], and dental implant in one case [9.1%]. Four cases had extensive sinusitis and were managed by endoscopic sinus surgery. Complete closure of the fistula was obtained in 10 cases [90.9%]. whereas one case [9.1%] failed. No other complications occurred The septal cartilage and pyramidal buccal flap technique is a viable alternative for the closure of large oroantral fistulas. The associated maxillary sinusitis can be safely managed by endoscopic sinus surgery

Treatment of posterior semicircular canal benign positional paroxysmal vertigo

This is a prospective study on 72 consecutive patients suffering from benign paroxysmal positional vertigo [BPPV] of the posterior semicircular canal. The study aimed at assessing the efficacy of the modified Epley maneuver for the treatment of BPPV and at evaluating the use of a mastoid vibrator on the treatment outcome and the recurrence of the disease. Other factors that might play a role on treatment success or disease recurrence were also studied. Using the Epley maneuver and without the use of the vibrator, 77.7% of patients were cured and 17.8%-improved, while 4.5% showed no improvement. In these cases, recurrence occurred in 8.9% of patients. Using a vibrator, 85.2% of the patients were cured and 14.8% improved, whereas recurrence in this group of patients occurred in 22.2%. The differences between both groups were not statistically significant. The overall recurrence in our series was 13.9% after an average follow-up period of 3 months. In the overall results, post-traumatic cases had significantly higher recurrences when compared with idiopathic cases. Other factors such as age, severity of the condition and duration of symptoms had no significant effect on the treatment success or on the recurrence of the disease