The problem of repairing a large alveolar-antral fistula of long standing is always difficult, and the surgeon is pressed to select a procedure which will most likely be successful in a given case. The many variations in operative procedure which have been proposed were reviewed by Ashley,1 who in addition described a method which he favored. Recently Hill2 discussed the matter again and suggested still another type of operation. Of all the methods that have been described, the latter is the only one that attempts to satisfy the principles set down in plastic surgery for repairing a defect in the wall of a body cavity—i. e., the construction of a lining and a covering. This has been a neglected aspect of the work probably because it is only of importance when the surgeon is dealing with large defects.
In the case reported here, the fistulous opening was so large and