What is the best method to detect an oral-antral fistula?

The nose blowing test is considered the best method to detect an oral-antral fistula due to its simplicity and effectiveness in demonstrating the connection between the oral cavity and the sinus. When a person blows their nose, the pressure created can help to identify the presence of an abnormal opening or fistula. If there is an oral-antral fistula, air and potentially fluid can escape from the oral cavity into the sinus, and vice versa, which can often be observed as a discharge or bubbling in the opposing cavity.

In contrast, while a CT scan is a highly detailed imaging technique that can provide good visualization of sinus anatomy and pathology, it may not directly demonstrate the functional aspect of the fistula as effectively as the nose blowing test. Similarly, X-ray imaging primarily offers a two-dimensional view and might not provide sufficient detail to diagnose an oral-antral fistula accurately. The saline contrast test, while useful in some contexts, doesn’t have the same direct functional assessment capability and is less practical for this specific situation. Thus, the nose blowing test stands out for its practical application in diagnosing oral-antral fistulas swiftly and effectively.