Abstract
The oral submucous fibrosis (OSMF) has been managed earlier by various medical and surgical modalities but none of these methods is found to give relief to these patients. Hence, a new method has been developed by us. Patients, who reported with pallor of the palate cheek, oropharyn and the tonsils, due to the fibrosis, leading on to mild, moderate to severe trismus, were given a good long-term rehef by this surgical method. This study involved 60 patients between 1979 and 2000 with a female-to-male ratio of 1∶3 with age ranging from 13 to 60 years suffering from the disease. The surgical method adopted in these cases used a single staged rotation tongue pedicle flap on either side from the dorsum of the tongue sutured to the raw area in the cheek without morbidity. In a 7-year follow up, we found the patients did not develop further fibrosis and the tongue flaps remained intact. The quality of life improved considerably and buccal mucosa is pink throughout the follow-up period. The modalities of treatment adopted are varied. Many tried the retro molar excision of the bands, which did not give long-term results. Others used excision of the whole fibrotic area with skin grafting, which also failed. Some have tried muscle pedicle flap from outside with postoperative morbidity and failure. Some surgeons have tried fat grafts in the cheek region (Yeh, Int J Oral Maxillo facial Surg 1996; 25; 130). The experience of the others who used versatile, vascular tongue flaps in the oral cavity after cancer clearance, prompted us to attempt this new technique in the present series with gratifying results. This is a break through in the surgical management of OSMF, where other treatment modalities failed.
Key Words: Oral submucous fibrosis (OSMF), pedicled tongue flap
Full Text
The Full Text of this article is available as a PDF (123.2 KB).
References
- 1.Mukherjee AL, Biswas SK. Oral submucons fibrosis—A search for etiology. Indian J Otolaryngol. 1972;24:11–5. [Google Scholar]
- 2.Pindborg JJ. Oral epithelial changes in thirty Indians with oral cancer in Submucous fibrosis. Cancer. 1967;20:1141–6. doi: 10.1002/1097-0142(196707)20:7<1141::AID-CNCR2820200717>3.0.CO;2-4. [DOI] [PubMed] [Google Scholar]
- 3.Murti PR, Bhonsle PB, Gupta PC, Duftary DK, Pindborg JJ, Mehta FS. Etrology of oral submucous fibrosis with special reference to role of arecanut chewing. J Oral Pathol. 1995;4:145–52. doi: 10.1111/j.1600-0714.1995.tb01156.x. [DOI] [PubMed] [Google Scholar]
- 4.Cox XC, Walker DM. Establishing a normal range for mouth opening: Its use in screening for oral submucous fibrosis. Br J Oral Maxillofac Surg. 1997;35:40–2. doi: 10.1016/S0266-4356(97)90007-3. [DOI] [PubMed] [Google Scholar]
- 5.Golkar S, Mahore MN, Narkhade S. Tongue flap in oral submucous fibrosis. Indian J Otolaryngol. 1989;41:104–7. [Google Scholar]
- 6.Khanna JR, Andrade NN Oral submucous fibrosis. A new concept in surgical management Report of 100 cases. Int J Oral Maxillofac Surg 1995, p. 433–9. [DOI] [PubMed]
- 7.Shklar G. Oral submucous carcinogenesis in hamsters. Inhibition by Vitamin E. J Natl Cancer Inst. 1982;68:791–7. [PubMed] [Google Scholar]
- 8.Zeiglar P-G. Areview of the epidemiological evidences that carotenoid reduce the risk of cancer. J Nutr. 1989;119:116–22. doi: 10.1093/jn/119.1.116. [DOI] [PubMed] [Google Scholar]
- 9.Joseff SG. Submucous fibrosis of palate and pillars. Indian J Otolaryngol 1953. p. 1–4.
- 10.Cjambras RG, Jaques DA, Mohoney WE. Tongue flaps for intraoral reconstruction. Am J Surg. 1969;118:783–783. doi: 10.1016/0002-9610(69)90229-3. [DOI] [PubMed] [Google Scholar]
- 11.Tepan MG, Saigal GS, Tilak SB. Use of tongue flap in submucous palatal fibrosis. J Laryngol Otol. 1986;100:455–60. doi: 10.1017/S0022215100099473. [DOI] [PubMed] [Google Scholar]
- 12.Lai DR, Chen HR, Llin LM, Huang YL, Tsai CC, Clinical evaluation of different treatment methods of oral submucous fibrosis—A ten year experience of 150 cases J Oral Pathol 1995, p. 402–6. [DOI] [PubMed]
- 13.Ramadass T, Thangavelu TA. Epidermolysis Bullosa and its ENT manifestations. J Laryngol Otol. 1979;888:184–6. doi: 10.1017/s0022215100085583. [DOI] [PubMed] [Google Scholar]
- 14.Tang JG, Ran XF, Gao ML, Ling TY, Ziang KH. Epidemiological survey of oral submucous fibrosis in Xiang city, Human Province—China. Community. Dent Oral Epidemiol. 1997;25:177–80. doi: 10.1111/j.1600-0528.1997.tb00918.x. [DOI] [PubMed] [Google Scholar]
- 15.Gulkar S, Mahore MN, Narkhode S. Tongue in oral submucous fibrosis. IJLO. 1969;4:104–7. [Google Scholar]