Uppada Uday Kiran
Department of Dentistry, All India Institute of Medical Sciences, Nagpur, India.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):6124-6130. doi: 10.1007/s12070-024-05063-2. Epub 2024 Sep 11.
This study is envisioned to assess the structural changes the muscles undergo beneath the submucosal tissues and whether these changes necessitate a novel strategy from the existing conventional modality in the treatment of oral submucous fibrosis (OSMF) medically through a systematic literature survey. Literature search was performed electronically using Medline, EMBASE and CENTRAL databases to identify published literature until the end of April 2024 in dental, oral and maxillofacial surgery, plastic surgery and otolaryngology journals containing the terms "oral submucous fibrosis", "muscles of mastication", "muscles of facial expression", "histopathologic study", "ultrasonographic study", "CT", "MRI" in either their titles, abstracts, and keywords with only English being the preferred language. The data was extracted from the selected articles and prudently studied to gather and compile the data. Descriptive data from all the carefully chosen articles were selected and analysed. Seven studies met the inclusion criteria. It was observed that the masseter muscle was the first to be involved in the disease process of OSMF among the muscles of mastication and facial expression. It was observed that the anterior temporalis and orbicularis oris muscles remained unaffected. However, the buccinator muscle which lies in utmost vicinity is not evaluated in the included studies. The degree of muscle degeneration and the degree of disease progression were directly related to the duration of the habit. The restricted mouth opening noticed in OSMF is not only governed by the subepithelial fibrosis but also on the extent of muscle degeneration. The changes the surrounding muscles undergo could be a manifestation of the disease, atrophy as a sequalae to the limited functional activity of the muscles which is brought about by fibrosis or it could be an essential part of the disease itself.
本研究旨在通过系统的文献综述，评估黏膜下组织下方肌肉所经历的结构变化，以及这些变化是否需要在医学上针对口腔黏膜下纤维化（OSMF）的现有传统治疗方式采用新的策略。使用Medline、EMBASE和CENTRAL数据库进行电子文献检索，以识别截至2024年4月底发表在牙科、口腔颌面外科、整形手术和耳鼻喉科期刊上的文献，这些文献的标题、摘要或关键词中包含“口腔黏膜下纤维化”“咀嚼肌”“面部表情肌”“组织病理学研究”“超声检查研究”“CT”“MRI”，且仅选择英文文献。从选定的文章中提取数据并进行审慎研究，以收集和汇编数据。选择并分析了所有精心挑选文章中的描述性数据。七项研究符合纳入标准。观察到在咀嚼肌和面部表情肌中，咬肌是最早参与OSMF疾病进程的肌肉。观察到颞肌前束和口轮匝肌未受影响。然而，纳入研究中未评估最邻近的颊肌。肌肉退化程度和疾病进展程度与习惯持续时间直接相关。OSMF中出现的张口受限不仅受上皮下纤维化的影响，还受肌肉退化程度的影响。周围肌肉所经历的变化可能是疾病的表现、因纤维化导致肌肉功能活动受限而产生的萎缩后遗症，也可能是疾病本身的重要组成部分。
