Lambade Pravin, Meshram Vikas, Thorat Pradip, Dawane Pawan, Thorat Ashutosh, Rajkhokar Dilpreet
Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India.
, 14, Nehru nagar, Near Surendra Nagar Basket Ball Ground, Nagpur, Maharashtra, 440015, India.
Oral Maxillofac Surg. 2016 Mar;20(1):45-50. doi: 10.1007/s10006-015-0519-0. Epub 2015 Aug 21.
Various surgical modalities have been used in the surgical management of oral submucous fibrosis with variable results. This prospective study evaluates the efficacy of nasolabial flap in the reconstruction of fibrotomy defect in surgical treatment of oral submucous fibrosis in terms of functional and esthetic outcomes.
In this prospective study, we treated 20 patients of oral submucous fibrosis surgically. The surgical protocol was consisting of bilateral fibrotomy, temporal myotomy, and coronoidotomy or coronoidectomy followed by reconstruction of fibrotomy defect with bilateral extended nasolabial flaps. All patients were prescribed with nutritional supplements and antioxidants. Vigorous mouth opening exercise was made compulsory for every patient. Preoperative and postoperative evaluation was done for interincisal mouth opening, function of mastication, and cosmetic results. Patient's regular follow-up was done for 2 years.
Postoperatively, we noted excellent increase in the interincisal mouth opening relieving trismus. Patient's ability to chew solid food was increased significantly. Extraoral scar was minimal and well accepted by all the patients. There was no morbidity of the donor site. There was no injury to the facial nerve in all cases. The only drawback was intraoral hair growth which went on reducing with mucosalization of the graft tissue.
Random pattern nasolabial flap is a very good option for intraoral reconstruction of fibrotomy defect in surgical treatment of oral submucous fibrosis with excellent functional and cosmetic results with minimal complications.
多种手术方式已用于口腔黏膜下纤维化的外科治疗,但其结果各异。本前瞻性研究从功能和美学效果方面评估鼻唇瓣在口腔黏膜下纤维化手术治疗中修复纤维切开术缺损的疗效。
在本前瞻性研究中,我们对20例口腔黏膜下纤维化患者进行了手术治疗。手术方案包括双侧纤维切开术、颞肌切开术和喙突切开术或喙突切除术,随后用双侧延长鼻唇瓣修复纤维切开术缺损。所有患者均接受营养补充剂和抗氧化剂治疗。要求每位患者进行积极的张口锻炼。对术前和术后的切牙间开口度、咀嚼功能和美容效果进行评估。对患者进行为期2年的定期随访。
术后,我们注意到切牙间开口度显著增加,牙关紧闭症状缓解。患者咀嚼固体食物的能力显著提高。口外瘢痕极小,所有患者均能很好接受。供区无并发症。所有病例均未损伤面神经。唯一的缺点是口内毛发增生,随着移植组织的黏膜化,这种情况逐渐减轻。
随意型鼻唇瓣是口腔黏膜下纤维化手术治疗中纤维切开术缺损口内修复的一个非常好的选择,功能和美容效果极佳,并发症极少。