Sharma Rohit, Thapliyal G K, Sinha Ramen, Menon P Suresh
Department of Oral & Maxillofacial Surgery, Military Hospital, Jalandhar, India.
J Oral Maxillofac Surg. 2012 Jan;70(1):228-32. doi: 10.1016/j.joms.2011.02.089. Epub 2011 May 6.
The aim of this study was to clinically evaluate the application of pedicled buccal fat pad (BFP) in the surgical management of stage III and IV oral submucous fibrosis (OSMF).
Twenty-eight cases of clinically and histologically diagnosed cases of OSMF were divided into 2 groups: group I (n = 15) and group II (n = 13), corresponding to clinical stage III and stage IV, respectively. All the patients underwent incision of fibrotic bands and coverage of the buccal defect with a pedicled BFP flap. Both groups were analyzed separately for mouth opening (interincisal distance in millimeters) preoperatively and 1 year postoperatively, time taken for epithelialization of BFP, time taken for establishment of normal contour, and changes in symptoms (painful ulcerations, burning sensation, and intolerance to spices) 1 year after grafting.
The mean preoperative mouth opening was 19.6 mm (SD, 2.43) in group I and 12.92 mm (SD, 1.21) in group II. The mean postoperative mouth opening after 1 year was 35 mm in group I (SD, 1.96) and 31.76 mm in group II (SD, 1.97). The time taken for epithelialization of BFP was 4 weeks in group I and 5 weeks in group II. The mean time taken for establishment of normal contour after grafting was 12.25 weeks (SD, 1.42) in group I and 15.07 weeks (SD, 1.26) in group II. In 2 cases in group II, there was remission of painful ulcerations, burning sensation, and intolerance to spices.
BFP is reliable for the treatment of OSMF.
本研究旨在临床评估带蒂颊脂垫（BFP）在Ⅲ期和Ⅳ期口腔黏膜下纤维化（OSMF）手术治疗中的应用。
28例经临床和组织学诊断的OSMF患者分为两组：Ⅰ组（n = 15）和Ⅱ组（n = 13），分别对应临床Ⅲ期和Ⅳ期。所有患者均接受纤维化条索切开术，并用带蒂BFP瓣覆盖颊部缺损。分别分析两组患者术前及术后1年的开口度（切牙间距离，单位为毫米）、BFP上皮化所需时间、建立正常外形所需时间以及移植后1年症状（疼痛性溃疡、烧灼感和对香料不耐受）的变化。
Ⅰ组术前平均开口度为19.6 mm（标准差，2.43），Ⅱ组为12.92 mm（标准差，1.21）。Ⅰ组术后1年平均开口度为35 mm（标准差，1.96），Ⅱ组为31.76 mm（标准差，1.97）。Ⅰ组BFP上皮化所需时间为4周，Ⅱ组为5周。Ⅰ组移植后建立正常外形的平均时间为12.25周（标准差，1.42），Ⅱ组为15.07周（标准差，1.26）。Ⅱ组有2例患者疼痛性溃疡、烧灼感和对香料不耐受症状缓解。
BFP治疗OSMF可靠。
