Combined triple approach for management of persistent oro - antral fistula

Fourteen patients with persistent oro-antral fistula following dental extraction were managed by a combined endonasal, sublabial and per-oral approach, under cover of antibiotic and metronidazole therapy. Endoscopic endonasal ethmoidectomy with middle meatal antrostomy, modified Caldwel-Luc approach and per-oral closure of the fistula mouth by a posteriorly based palatal flap was our surgical technique. Results were very satisfactory without any major complications