The story of suitable treatment options for a fistula is quickly told. Once the cause of the fistula is identified, steps need to be taken to eliminate the underlying cause. This could be local infection or an abscess, retained or fractured root fragments from a dental extraction, or necrotic bone. Without eliminating the underlying cause treatment of a fistula on its own will not be successful, the fistula will recur.

Apart from this general requirement of eradicating the underlying cause (where possible), the fistula simply needs to be surgically removed. It is essential that the entire tract of the fistula is excised before the resulting wound is closed. The exact method for closure of the wound depends on site and extent of the fistula (Figure 1).

Figure 1: It is essential to excise the fistulous tract before closure of an established oroantral fistula.

Next section: Fistula