Retrospective comparison of surgical treatment modalities in 100 patients with oral submucous fibrosis.

BACKGROUND AND OBJECTIVE

Oral submucous fibrosis has been a scourge of southeastern Asia and its residents since time immemorial. Scores of medicinal agents, singly and in combination, have been tried with not very encouraging results. In this study, therefore, we have restricted ourselves to different surgical modalities in the management of this condition and have tried to lay down indications of each surgical procedure.

STUDY DESIGN

A total of 100 patients of oral submucous fibrosis were included in this study and randomly allocated to different surgical groups, 25 patients per group. After excision of fibrous bands, group I had buccal fat pad graft, group II had tongue flap, group III had nasolabial fold flap, and group IV had split skin graft for correction of mucosal defect created after incising the fibrous bands.

RESULTS

Mean preoperative mouth opening was 14.82 (SD 4.38) mm and ranged between 4.00 and 25.00 mm. Statistically there was no significant difference among the 4 groups (P = .996). Mean postoperative mouth opening at 1 week was 35.79 (3.53) mm, ranging between 24.00 and 42.00 mm. Mean postoperative mouth opening at 1 month in group I was 36.36 (2.64) mm, in group II 35.36 (29) mm, in group III 35.64 (2.94) mm, and in group IV 35.80 (3.24) mm. Total score for pain, esthetics, and function at 1 month after surgery was highest (11.29) in group I, indicating better results.

CONCLUSION

The results were very encouraging, and we were able to lay down specific indications for each procedure. However, we believe buccal fat pad rotation is superior to other procedures, because it offers ease of surgery, can be performed under local anesthesia as a day care procedure, shows little postoperative morbidity, and has good patient acceptance, and there appear to be no contraindications to its use.