Surgical management of Oral submucous fibrosis
DOI:
https://doi.org/10.7439/ijbar.v7i5.3190Abstract
Background: Oral submucous fibrosis (OSF), globally accepted as an Indian disease, has one of the highest rates of malignant transformation amongst potentially malignant oral lesions and conditions. The hallmark of the disease is submucosal fibrosis that affects most parts of the oral cavity, pharynx and upper third of the esophagus leading to dysphagia and progressive trismus due to rigid lips and cheeks. Nonsurgical measures like local steroids, hyaluronidase injections, vitamin supplements and jaw opening exercises have poor results. There lack of guidelines for choosing the surgical procedures. Methods: This prospective study was done on 13 cases of clinically diagnosed oral submucous fibrosis during 2012-2015. After diagnosis these patients are grouped according to the severity of the disease proposed by Chandramani More. The patients underwent either release and split skin grafting or Nasolabial flap or Superficial temporal artery fascial flap for intra oral cover. The results were analysed for postoperative mouth opening and complications. Results : Of the total 13 patients studied 8 were male and 5 females. The age ranged from 22 years to 68 year (Mean= 43 years). Preoperative functional stage was ten patients 15-25mm mouth opening (M3) and three patient 15mm mouth opening (M4) Mean preoperative mouth opening was 16.7mm. The procedure performed was release with split skin graft in six patients, release with Nasolabial flap cover in two patients and release with superficial temporal artery flap cover with graft in five patients. Mean post operative mouth opening was 35.6mma at follow up of 6 months. Conclusion : Surgical correction of oral submucous fibrosis offer better outcome than conservative management. The choice of surgical procedure depends on patient profile. Flap covers are better than split skin graft in term of recurrances. Nasolabial flap cover can be used in elderly with lax skin. The superficial temporal artery fascial flap cover has advantage of lesser morbidity and more suited in cases of severe restriction of mouth opening.Downloads
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