Facial artery musculomucosal flap to close an oroantral fistula

Oroantral fistulas (OAF), which develop as a result of maxillary sinus infection caused by oroantral communication, are sometimes intractable. We present a case of closure with a facial artery musculomucosal flap (FAMM flap) for intractable OAF. A 73-year-old man presenting with an OAF and rhinorrhea was referred to our department. Twenty-eight years earlier, he had undergone bilateral radical surgery for maxillary sinusitis, and six years earlier, he underwent extraction of his right maxillary first and second molars. Six months after the dental extractions, he developed maxillary sinusitis secondary to oroantral communication. Four years after the dental extractions, he underwent endoscopic sinus surgery with closure of the OAF with a rotational pedicled palatal flap, but the OAF recurred. To treat the OAF recurrence, we used a FAMM flap. His postoperative course was good, with no OAF recurrence 6 years after surgery. FAMM flaps are useful to close intractable OAFs.