Pathology · patient case question
An oroantral communication of less than 2 mm in a patient with an otherwise healthy sinus is best managed by:
Patient case: Post-Extraction Sinus Findings
demo: 52-year-old male
chief: Extraction of a non-restorable maxillary first molar.
history: Chronic nasal congestion and post-nasal drip for two years. Non-smoker.
meds: None
findings: After extraction of #14, soft tissue was retrieved from the socket and submitted for histopathology. The report describes pseudostratified ciliated columnar epithelium with a chronic inflammatory infiltrate.
Show answer and explanation
Correct answer: B. Conservative measures — clot preservation, sinus precautions, and follow-up
- A. Long-term packing keeps the tract epithelialized and encourages a permanent fistula.
- B. Correct. Small communications under about 2 mm usually close spontaneously if the clot is preserved and the patient follows sinus precautions — no nose blowing, no straws, no smoking.
- C. Flap closure is reserved for larger defects, generally 5 mm or more, or for persistent communications.
- D. Caldwell-Luc is a major antrostomy procedure reserved for chronic sinus disease, not a small fresh communication.