Clinical and Histological Basis for the Use of Nasolabial Tissues in the Surgical Management of Oral Submucous Fibrosis

Abstract

The authors planned a clinical and histopathologic study to examine the behavior of nasolabial tissues (full-thickness skin flap) after being inset into the oral cavity for oral submucous fibrosis (OSMF) under the premise that skin that is foreign tissue to the oral cavity would be devoid of pathologic changes. Fourteen patients with OSMF and mouth openings with an interincisal distance shorter than 28mm were included. The flap was evaluated clinically for 10years, during which biopsy specimen was obtained from the mucocutaneous junction of the inset flap for histopathologic examination. In this series, complications such as flap loss, infection, flap necrosis, obstructive sialadenitis, and damage to facial nerve branches were not observed. However, intraoral hair growth and extraoral scar at the donor site were seen in all patients, 3 of whom subsequently underwent scar revision. Histopathologically, the inset flap showed decreased keratinization and loss of adnexal structures. A mean mouth opening of 43.2mm was achieved at 10years postoperatively (mean increase, 24.4mm). No relapse was encountered, even at the last follow-up. The nasolabial island flap or any other full-thickness skin flap could be a viable and reliable option for reconstruction of intraoral defects from OSMF.