Tulsidas Singh Wahengbam, Bhola Nitin, Singh Deepak N, Agarwal Anchal, Aparna Devi Potsangbam, Aheibam Kiran Kumar
Department of Oral and Maxillofacial Surgery, Dental College, Regional Institute of Medical Sciences, Imphal, IND.
Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, IND.
Cureus. 2024 May 14;16(5):e60297. doi: 10.7759/cureus.60297. eCollection 2024 May.
To evaluate the effectiveness of nasolabial flap (NLF), a buccal pad of fat flap (BFP), and platysma myocutaneous flap (PMF) for reconstruction following fibrotomy for individuals with oral submucous fibrosis (OSMF).
A retrospective study was conducted among patients diagnosed with grade III and IV OSMF in the Department of Oral and Maxillofacial Surgery at Sharad Pawar Dental College between January 2016 and August 2018. The essential patient information was obtained from the Medical Record Department (MRD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Sawangi (Meghe) Wardha. The patients were categorized into three groups: the NLF, the BFP, and the PMF groups. Each group had 16 patients, and factors such as interincisal width, diminished burning sensation in the mouth, inter-commissure distance, and flap necrosis were compared pre- and post-operatively. Student's unpaired t-test and chi-square test were employed for statistical analysis.
Mean interincisal mouth-opening increased from pre-operative 4.79 to 41.42 mm post-operatively in the NLF group, BFP group from 6 to 39.42 mm and in the PMF group from 9.26 to 39.34 mm with p value=0.0001. NLF group showed complete and partial resolution of the burning sensation of the mouth at 93.75% and 6.25%, BFP at 62.25% and 32.75% while in PMF it was 68.5% and 31.25% respectively. One year postoperatively 3.28 mm increase in inter-commissure width was observed in the NLF group with a marginal increase in the PMF group and a negligible increase in the BFP group. 18.75% partial flap necrosis was seen in BFP, 18.75% in the PMF group, and 6.25% in the NFL group.
All the flaps are efficacious in treating OSMF, however, NLF stands ahead with its higher reliability owing to its excellent blood supply.
评估鼻唇瓣（NLF）、颊脂垫瓣（BFP）和颈阔肌肌皮瓣（PMF）在口腔黏膜下纤维化（OSMF）患者纤维切开术后重建中的有效性。
对2016年1月至2018年8月期间在沙拉德·帕瓦尔牙科学院口腔颌面外科诊断为III级和IV级OSMF的患者进行回顾性研究。基本患者信息从达塔·梅赫医学科学研究所（DMIMS）萨万吉（梅赫）瓦尔达的阿查里亚·维诺巴·巴韦农村医院（AVBRH）的病历科（MRD）获取。患者分为三组：NLF组、BFP组和PMF组。每组16例患者，比较术前和术后的切牙间宽度、口腔烧灼感减轻、口角间距和皮瓣坏死等因素。采用学生非配对t检验和卡方检验进行统计分析。
NLF组切牙间平均开口度从术前的4.79mm增加到术后的41.42mm，BFP组从6mm增加到39.42mm，PMF组从9.26mm增加到39.34mm，p值 = 0.0001。NLF组口腔烧灼感完全和部分缓解率分别为93.75%和6.25%，BFP组为62.25%和32.75%，PMF组分别为68.5%和31.25%。术后一年观察到NLF组口角宽度增加3.28mm，PMF组略有增加，BFP组增加可忽略不计。BFP组皮瓣部分坏死率为18.75%，PMF组为18.75%，NFL组为6.25%。
所有皮瓣在治疗OSMF方面均有效，然而，NLF因其良好的血供而具有更高的可靠性，领先于其他皮瓣。
