Oro-antral fistula

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Post-tooth extraction with right upper jaw throbbing pain and swelling.

Patient Data

Age: 50 years
Gender: Male
ct

Post tooth extraction. 

Loss of the right upper premolars and first two molar teeth.

Underlying focal osseous defect of the alveolar process of the maxilla (floor of the right maxillary antrum) which is seen filled by inflammatory soft. The posterior aspect of the right alveolar rim shows patchy sclerosis with extra-osseous inflammatory changes are seen involving the right buccinators muscle as well as the right aspect of the tongue. 

Clear both maxillary antra. 

Unerupted 3rd molar bilaterally, being bulging into the corresponding maxillary antrum. 

Bilateral multiple mildly enlarged cervical lymph nodes seen at all stages with subcentimetric short axes (non-specific). 

Incidentally noted is mild bilateral ethmoiditis. 

Case Discussion

Status post-tooth extraction with right oro-antral fistula and osteomyelitis of the right posterior alveolar margin and extra-osseous inflammatory soft tissue mass lesion as described.

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