The aim of this work is to describe a relatively new technique for closure of large oroantral fistulas. Fistulas were treated surgically using autograft septal cartilage and a buccal pyramidal flap. There were 11 patients, 8 of whom had chronic oroantral fistulas. Four cases had extensive sinusitis and were managed by endoscopic sinus surgery. Complete closure of the fistula was obtained in 10 cases (90.9%), whereas 1 case (9.1%) failed. No other complications occurred. The septal cartilage and pyramidal buccal flap technique is a viable alternative for the closure of large oroantral fistulas.
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