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An oroantral fistula (OAF) is an epithelialized oroantral communication (OAC), which refers to an abnormal connection between the oral cavity and the antrum. [1] The creation of an OAC is most commonly due to the extraction of a maxillary tooth (typically a maxillary first molar) which is closely related to the antral floor.
Tracheoesophageal fistula is suggested in a newborn by copious salivation associated with choking, coughing, vomiting, and cyanosis coincident with the onset of feeding. Esophageal atresia and the subsequent inability to swallow typically cause polyhydramnios in utero. Rarely it may present in an adult. [1]
Alternative treatments were also offered. Many rejected the harsh side effects of mercury, claiming their cures were made of "natural" or "vegetable" ingredients. Patent medicines labeled as sarsaparilla were recommended for scrofula. [14] Examples of treatments recommended between the 17th and 19th century include the following:
The median time to definitive repair from fistula onset was 6 months (range 1 day to 28 months). The 6-month time course is commonly utilized by groups with significant experience treating fistulas, owing to the trend in encountering a less hostile abdomen than in the early phases. [ 4 ]
The fistula can communicate with the mouth (usually causing no symptoms), the paranasal sinuses (giving rhinorrhea) [1] or the facial skin (causing saliva to drain onto the skin). The usual cause is trauma, however salivary fistula can occur as a complication of surgery, or if the duct becomes obstructed with a calculus .
“In adults over the age of 65, symptoms almost always include a cough, whereas with the flu, coughing is usually just present in about two-thirds of patients,” he says.
Courses of treatment typically include the following: [13] Surgical excision is indicated with recurrent fistular infections, [ 14 ] preferably after significant healing of the infection. In case of a persistent infection, infection drainage is performed during the excision operation.
Frank's sign is a diagonal crease in the ear lobe extending from the tragus across the lobule to the rear edge of the auricle. [1] The sign is named after Sanders T. Frank. [1] It has been hypothesised that Frank's sign is indicative of cardiovascular disease [2] [3] and/or diabetes. [4]