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ELna,
Please don't lose hope. The oral surgeon did the Wassmund-Rehrmann-lobe procedure because he could not leave the fistula into the sinus wide open. The reason to close it is because bacteria can get up inside and travel to you brain. So there has to be some attempt made to close it. This procedure is very difficult and tedious with no guarantees it's going to be completely successful. There is also no way to know how well the tissue will heal at the surgical site, especially if there is something else brewing in that area. If the fistula remains open, it may be related to bacteria stemming from an adjacent tooth which could prevent the hole from healing closed. You may have told me.... but has anyone explained to you why there was a severe sinus communication in the first place? Bryanna Quote:
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Oh no I think he could have and should have left it alone there and then since there's been a closing attempt just 2 days prior to that and the area was too damaged for anything further to do any good. Plus, he made me have the operation by scaring me how it would NEVER heal on its own and how I would need a major sinus surgery if it was left open.
Not true. The perforation was larger than ever before 5x5 mm 2 weekys post-surgery then after it recovered from whatever damage he did it it started to heal on its own and is almost fully closed - no air movement only some water still gets to wet my nose. But it DID heal on its own as it might have in the first place if it was left alone. Plus, he said I might not be able to get an implant in the area but the the fact that I'll be ruined or that I'll be unable to have a denture ever was never mentioned because I think he didn't know what he was doing. No, there did not have to be am attempt to close it there and then and this way. If the procedure is knowingly so difficult with no guarantees should not I had been given a CHOICE? He acted like it was nothing. There was nothing else brewing in the area only what he put there. The fistula is closing on its own now after the site recovered from the totally useless but absolutely destroying procedure he decided to force on me without my knowledge. There wasn't a severe communication, it was a perforation that happens, left alone, I would be over the whole thing. The fact that it might have been his first W-R lobe might have not helped as I found out along with how quickly he left his practice AND the country for good 2 weeks after the operation. So yes, maybe it's all my fault and my body's fault but I surely would have said no if I knew the risks and the certainties. I'm not worried about the communication because I trust it will fully heal on its own now, I'm worried about the damage done. |
ELna,
That procedure is done in extreme cases where there is a large opening from the jaw bone into the sinus. It is not done on small perforations. I think the first attempt at closing the opening was ineffective for whatever reason, possibly poor technique or inexperience or the dentist did not realize the actual severity of the opening. Also, some ora-antral fistulas do not actually form completely until a few days post op. Which could also be a factor in your case. These communications between the mouth and the sinus can be very complicated and difficult to treat especially if there is other pathology going on in or near that area. From the way you have described this, I feel it would have been unethical for him not to attempt to close the opening. But I was not there and did not see the actual OAC or OAF. I do think he should have explained the situation to you much better prior to doing the surgery and in that explanation told you why this opening occurred in the first place. I think part of your frustration is over the way you were treated at the beginning by not just him but the other dentist as well. Which is totally understandable. Here is a link that describes the procedure. It's a bit technical but you may get something worthwhile out of it. http://www.medfak.ni.ac.rs/ASN/BROJ-...ull%20text.htm When you say it has healed on it's own. Are you referring to the hole in the gum tissue and/or the hole in the bone into the sinus? Bryanna Quote:
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Exactly. There wasn't an extreme case. There was an overly eager surgeon who actually said before the operation hmmm where should I take the gum from and he chose the procedure because he remembered he could take gum from there not because of the hole itself. According to him the only reason the first operation wasn't successful might be because of a piece of sharp bone around the area where the gum tissue used during the first surgery might have broke so he took care of that. He had no idea of the consequences he would be causing. There is a reason he left. It wasn't an extreme hole or anything else going on he clearly chose an unnecessary procedure. Thank you for clearing that up for me. I also wish everyone was like you but they are not Bryanna. There might not be a good, noble reason behind his actions. He simply might not be good. Thank you again, for everything.
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ELna,
I am not defending his technique as I was not there to see the surgery. I've never witnessed this closure technique unless the situation warranted it. I have seen, too many times, botched up closures :/ Even simple ones. So I unfortunately know that does happen :/ Here is another link that explains the buccal fat pad that is used for the closure. It also gives photos... warning, they are explicit. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510921/ Bryanna Quote:
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