Severe Oral Submucous Fibrosis Research Articles

Surgical management of advanced oral submucous fibrosis: our experience

<p class="abstract"><strong>Background:</strong> Severe oral submucous fibrosis (OSMF) poses problem with maintenance of oral hygiene,detection of malignancies and maintenance of nutrition. Surgical treatment includes release of fibrous bands with or without reconstruction for the raw area and postoperative physiotherapy.</p><p class="abstract"><strong>Methods:</strong> All cases with OSMF who underwent surgical management at our institute were included in our study. The demographic data, preoperative interincisor distance, local examination was recorded. All patients underwent contrast enhanced computed tomography scan of head and neck to rule out hidden malignancy. All cases underwent OSMF band release with or without reconstruction. All patients were instructed for vigorous mouth opening exercise. All patients were followed upto 6 months and further divided into two groups depending upon whether they followed physiotherapy advice or not.</p><p class="abstract"><strong>Results:</strong> 13 patients of age group 18-47 years were included in our study. Male to female ratio was 1.6:1. Pre-operative mean interincisor distance was 7.5 mm whereas post-operative it was 19.5 mm. Patients who had followed mouth opening exercise were having a mean increase of 15 mm more as compared to those who did not.</p><p><strong>Conclusions:</strong> Even after surgical management of severe OSMF, mouth opening exercise remains the key factor for maintenance of mouth opening.</p>

Association Between Grading of Oral Submucous Fibrosis With Frequency and Consumption of Areca Nut and Its Derivatives in a Wide Age Group: A Multi-centric Cross Sectional Study From Karachi, Pakistan.

Background:Oral submucous fibrosis (OSMF) is a chronic, premalignant condition of the oral mucosa and one of the commonest potentially malignant disorders amongst the Asian population. The objective of this study was to investigate the association of etiologic factors with: age, frequency, duration of consumption of areca nut and its derivatives, and the severity of clinical manifestations.Methods:A cross-sectional, multi centric study was conducted over 8 years on clinically diagnosed OSMF cases (n = 765) from both public and private tertiary care centers. Sample size was determined by World Health Organization sample size calculator. Consumption of areca nut in different forms, frequency of daily usage, years of chewing, degree of mouth opening and duration of the condition were recorded. Level of significance was kept at P ≤ 0.05.Results:A total of 765 patients of OSMF were examined, of whom 396 (51.8%) were male and 369 (48.2%) female with a mean age of 29.17 years. Mild OSMF was seen in 61 cases (8.0%), moderate OSMF in 353 (46.1%) and severe OSMF in 417 (54.5%) subjects. Areca nut and other derivatives were most frequently consumed and showed significant risk in the severity of OSMF (P ≤ 0.0001). Age of the sample and duration of chewing years were also significant (P = 0.012).Conclusions:The relative risk of OSMF increased with duration and frequency of areca nut consumption especially from an early age of onset.

Surgical Management of OSMF With Coronoidectomy and Buccal Fat Pad Replacement - A Case Report

Oral submucous fibrosis is a chronic, progressive, disabling and scarring disease that affects the entire oral cavity, sometimes the pharynx, and rarely the larynx which predominantly affects the people of southeast Asia. It is characterized by blanching and stiffness of the oral mucosa, which causes progressive limitation of mouth opening and intolerance/ burning sensation to hot and spicy food and ulceration and pain. . Numerous non-surgical and surgical methods have been employed for treatment of this debiliting disease. In this article a case is being reported with severe oral submucous fibrosis which is surgically managed with coronoidectomy and buccal fat pad replacement.

Tripaddled anterolateral thigh flap for simultaneous reconstruction of bilateral buccal defects after buccal cancer ablation and severe oral submucous fibrosis release: A case report

For buccal squamous cell carcinoma (SCC) patients accompanied with severe oral submucous fibrosis (OSF), it is a challenge to simultaneously reconstruct bilateral buccal defects created from cancer resection and contralateral OSF release to improve postoperative mouth opening. Herein, we present a case of reconstruction of bilateral buccal defects in a 46-year-old patient who had left buccal SCC accompanied with severe OSF. Extensive ablation involved the left full-thickness cheek as well as part of mandible and a release of right OSF tissue were performed. A tripaddled anterolateral thigh (ALT) flap with three independent sets of perforators was harvested for reconstruction. The flap survived in its entirety. No donor or recipient site complication occurred. The preoperative inter-incisor distance (IID) was 1 mm, while the postoperative IID was 23 mm. This is the first report on the use of one tripaddled ALT flap for reconstruction of bilateral buccal defects created from cancer ablation and severe contralateral OSF release.

Excision of Oral Submucous Fibrosis and Reconstruction with Full Thickness Skin Graft: A Case Study and Review of the Literature

Oral submucous fibrosis is a chronic debilitating disease characterized by gradually increasing fibrosis of the oral cavity and pharynx, mainly the buccal mucosa, resulting in trismus. The highest incidence of oral submucous fibrosis is seen in South India due to various deleterious habits. In spite of the numerous medical modalities employed in the management of oral submucous fibrosis, occasionally surgical intervention becomes inevitable. Various surgical approaches have been used to reconstruct the surgical defects following excision of fibrous bands. Full thickness skin grafts have been described in the literature with variable outcomes. In the present study a 38-year-old male presented with severe oral submucous fibrosis of the buccal mucosa, which was successfully treated and reconstructed using full thickness skin graft with stable functional result after one year of treatment. An integrated review of the literature regarding etiology, histopathology, diagnostic, and treatment modalities of the disease follows.

Increased severity of oral submucous fibrosis in young Pakistani men

Objective—To investigate the influence of age and sex on the incidence of severe oral submucous fibrosis (mouth opening 15 mm or less). Design—Case (severe disease) control (mild disease) study. Setting—University hospital, Pakistan. Subjects—147 patients with severe (mouth opening 15 mm or less) and 83 with mild disease (mouth opening 20 mm or more). Main measures—Influence of sex and age on severity of oral submucous fibrosis. Results—Men were twice as likely as women to have severe disease (odds ratio (OR) 2.0, 95% confidence interval (CI) of OR 1.15 to 3.47, P=0.02). Men in the 20–39 year age group were 4.8 times as likely as women to have severe disease (OR 5.8, 95% CI 2.15 to 15.5, P=0.00004). Men aged 40 years or more were 40% less likely to have severe disease than women (OR 0.6, 95% CI 0.19 to 1.88, P=0.39). Conclusions—Smoking increases the carcinogenic potential of submucous fibrosis. As men in this population smoke more than women, men with severe oral submucous fibrosis may develop oral cancer and die younger. Alternatively, young men may consume more areca nut than women.