Efficacy of Bichat’s Buccal Fat Pad Advancement in the Treatment of Odontogenic Maxillary Sinus Fistulas

Abstract

Background/Objectives: Oroantral fistulas (OF) are a challenging complication in oral and maxillofacial surgery, often requiring surgical intervention to restore sinus integrity. The Bichat’s buccal fat pad (BFP) has gained attention as a viable option for OF closure. This study aimed to evaluate the efficacy, safety, and clinical outcomes of BFP advancement for OF treatment. Methods: This prospective study included 20 patients diagnosed with OF. The surgical procedure involved isolation and advancement of the BFP to close the defect. Patients were followed up at 7 days, 45 days, and 6 months postoperatively, with clinical and radiographic assessments. The primary outcome was successful fistula closure at 6 months, while secondary outcomes included complication rates, sinus opacification on CT scans, pain levels, and quality of life improvements. Results: The overall success rate was 85.7%, with complete fistula closure achieved in 18 out of 21 cases (including one bilateral case). Minor complications occurred in 14.3% of cases. CT scans at 6 months showed complete resolution of sinus opacification in 81% of cases. Patients reported significant improvements in pain scores and quality of life. Conclusions: BFP advancement is an effective, safe, and minimally invasive technique for OF closure, offering high success rates and favorable clinical and radiographic outcomes. These findings support the use of BFP as a reliable option for managing OF in oral and maxillofacial surgery.

Keywords

• oroantral fistula
• Bichat’s buccal fat pad
• oral reconstructive surgery
• odontogenic sinusitis
• oro-sinus communication