Skip to main content

Advertisement

Log in

Surgical Interventions in Oral Submucous Fibrosis: A Systematic Analysis of the Literature

  • Review Paper
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Background

Oral submucous fibrosis (OSMF) is a potentially malignant disorder of the oral cavity. The surgical management of this condition involves excision of the fibrotic bands and interpositional grafts to retain the increased oral opening. Various procedures and graft material have been utilised with differing success rates.

Objectives

The present review aims to collate and analyze from world literature the different modalities utilized in the surgical management of OSMF. The reasons for the choice of a particular surgical procedure, the study protocol, the average follow-up period and the results were scrutinized.

Materials and Methods

The PRISMA protocol was followed for the systematic review. Search engines and medical databases like Ovid, Medline, Pubgate, Researchgate, PubMed, Google etc. were tapped for information related to the subject. The search words “OSMF”, “surgical interventions in OSMF”, “flaps and grafts in treatment of OSMF” were employed for retrieval of data. An analysis of the treatment modalities, the reason for the selection of a particular modality, the organization of the sample selection and the follow-up periods including the proclaimed success rates was done.

Results

The review resulted in a total of 56 articles on the subject from the sources mentioned above. A total of 995 surgically treated cases were included in the analysis. Interestingly the review revealed very few controlled clinical trials, most being random trials on surgical procedures in small groups of patients with very short follow up periods. The choice of procedure seems to be determined entirely by the preference of the operator/s.

Conclusions

There exist no definite protocols for the adoption of a particular treatment mode in OSMF. Adequate documentation and follow up need to be established to statistically analyse the results and proclaimed successes of various treatment modalities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Pindborg JJ, Sirsat SM (1966) Oral submucous fibrosis. Oral Surg 22:764–768

    Article  CAS  PubMed  Google Scholar 

  2. Moher D, Liberati A, Tetzlaff J, Altman DG, and the PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269

    Article  PubMed  Google Scholar 

  3. Chaaya VA, Sinha V, Rathor R, Modi N, Rashmi GS, Parmar V et al (2010) Oral submucous fibrosis surgical treatment with CO2 laser. World Artic Ear Nose Throat 3:1–2

    Google Scholar 

  4. Chaudhary Z, Verma M, Tandon S (2011) Treatment of oral submucous fibrosis with ErCr:YSGG laser. Indian J Dent Res 22:472–474

    Article  PubMed  Google Scholar 

  5. Kameshwaran M, Raghavan D, Anand Kumar RS, Murali S (2007) Surgical management of trismus due to oral submucous fibrosis—lysis of fibrotic bands with the KTP-532 laser. Indian J Otolaryngol Head Neck Surg 58:229–231

    Google Scholar 

  6. Nayak DR, Mahesh SG, Agrawal D, Pavithran P, Pujary K, Pillai S (2009) Role of KTP-532 laser in management of oral submucous fibrosis. J Laryngol Otol 123:418–421

    Article  CAS  PubMed  Google Scholar 

  7. Shah A, Raj S, Rasaniya V, Patel S, Vakade M (2005) Surgical management of oral submucous fibrosis using “Opus 5” diode laser. J Oral Laser Appl 5:37–43

    Google Scholar 

  8. Murugavel C, Gnanam T, Roopesh (2012) A modified approach using diode laser to reduce trismus in oral submucous fibrosis. Kerala State Dent J 35:224–228

    Google Scholar 

  9. Talsania JR, Shah UB, Shah AI, Singh NK (2009) Use of diode laser in oral submucous fibrosis with trismus. Prospective study. Ind J Otolaryngol Head Neck Surg 61:22–25

    Article  Google Scholar 

  10. Chang Y-M, Tsai C-Y, Kildal M, Wei F-C (2004) Importance of coronoidectomy and masticatory muscle myotomy in surgical release of trismus caused by submucous fibrosis. Plast Reconstr Surg 113:1949–1954

    Article  PubMed  Google Scholar 

  11. Bhrany AD, Izzard M, Wood AJ, Futran ND (2007) Coronoidectomy for the treatment of patients in head and neck cancer. Laryngoscope 117:1952–1956

    Article  PubMed  Google Scholar 

  12. Tepan MG, Saigal GS, Tilak SB (1986) Use of tongue flap in submucous palatal fibrosis. J Laryngol Otol 100:455–460

    Article  CAS  PubMed  Google Scholar 

  13. Mehrotra D, Pradhan R, Gupta S (2009) Retrospective comparison of surgical treatment modalities in 100 patients with oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 107:1–10

    Article  Google Scholar 

  14. Ramadass T, Manokaran G, Pushpala SM, Narayanan N, Kulkarni GN (2005) Oral submucous fibrosis—new dimensions in surgery. Indian J Otolaryngol Head Neck Surg 57(2):99–102

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Golhar S, Mahore MN, Narkhede S (1989) Tongue flap in oral submucous fibrosis. Indian J Otolaryngol Head Neck Surg 41:104–107

    Google Scholar 

  16. Khanna JN, Andrade NN (1995) Oral submucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral Maxillofac Surg 24:433–439

    Article  CAS  PubMed  Google Scholar 

  17. Adeyemo WL, Ladeinde AL, Ogunlewe MO, Bambgbose BO (2004) The use of buccal fat pad in oral reconstruction. Niger Postgrad Med J 11:207–211

    CAS  PubMed  Google Scholar 

  18. Girotra C, Padhye M, Desai R (2008) Verastility of buccal fat pads in closure of oral defects. Sci J 8:1–3

    Google Scholar 

  19. Jeevan Kumar KA, Brahmaji Rao J (2009) Versatility of pedicled buccal fat pad in surgical management of oral submucous fibrosis—a study in 20 cases. Indian J Dent Adv 1:5–11

    Google Scholar 

  20. Chao C-K, Chang L-C, Liu S-Y, Wang J-J (2002) Histologic examination of pedicled buccal fat pad graft in oral submucous fibrosis. J Oral Maxillofac Surg 60:1131–1134

    Article  PubMed  Google Scholar 

  21. Yeh CJ (1996) Application of the buccal fat pad to the surgical treatment of oral submucous fibrosis. Int J Oral Maxillofac Surg 25:130–133

    Article  CAS  PubMed  Google Scholar 

  22. Pandya H, Patel H, Dewan H, Babaria U, Bhavsar B, Thakkar D et al (2011) Comparison of nasolabial flap versus buccal fat pad graft for management of submucous fibrosis. J Dent Sci 1:6–7

    Google Scholar 

  23. Sharma R, Thapliyal GK, Sinha R, Menon PS (2011) Use of buccal fat pad in the treatment of oral submucous fibrosis. J Oral Maxillofac Surg. doi:10.1016/j.joms.2011.02.089

    Google Scholar 

  24. Lai DR, Chen HR, Lin LM, Huang YL, Tsai CC (1995) Clinical evaluation of different treatment methods for oral submucous fibrosis. A 10-year experience with 150 cases. J Oral Pathol Med 24:402–406

    Article  CAS  PubMed  Google Scholar 

  25. Nataraj S, Guruprasad Y, Shetty JN (2011) A comparative clinical evaluation of buccal fat pad and collagen in surgical management of oral submucous fibrosis. Arch Dent Sci 2:15–22

    Google Scholar 

  26. Krishna Prasad L, Chakravarthy PS, Sridhar M, Ramkumar S, Krishna S, Vivekanand SK (2009) An evaluation of various treatment modalities in the management of oral submucous fibrosis. A clinical study. J Orofac Sci 1(2):17–20

    Google Scholar 

  27. Gupta LC, Kohli M, Punn K, Abhishek (2011) Use of buccal fat pad in oral submucous fibrosis. A case report. Asian J Oral Health Allied Sci 1:51–52

    Google Scholar 

  28. Mehta AK, Panwar SS, Verma RK, Pal AK (2003) Buccal Fat Pad reconstruction in oral submucous fibrosis. Med J Armed Forces Inst 59:340–341

    Article  Google Scholar 

  29. Surej Kumar LK, Kurein NM, Sakkir N (2010) Buccal fat pad reconstruction for oral submucous fibrosis. Nat J Maxillofac Surg 1:164–167

    Article  CAS  Google Scholar 

  30. Saravanan K, Narayanan V (2012) The use of buccal fat pad in the treatment of oral submucous fibrosis: a newer method. Int J Dent. doi:10.1155/2012/935135

    PubMed Central  PubMed  Google Scholar 

  31. Kothari MC, Hallur N, Sikkerimath B, Gudi S, Kothari CR (2012) Coronoidectomy, masticatory myotomy and buccal fat pad graft in the treatment of advanced oral submucous fibrosis. Int J Oral Maxillofac Surg 41:1416–1421

    Article  CAS  PubMed  Google Scholar 

  32. Borle RM, Nimonkar PV, Rajan R (2009) Extended nasolabial flaps in the management of oral submucous fibrosis. Br J Oral Maxillofac Surg 47:382–385

    Article  CAS  PubMed  Google Scholar 

  33. Maria A, Sharma Y, Kaur P (2011) Use of nasolabial flap in the management of oral submucous fibrosis—a clinical study. People’s J Sci Res 4:28–30

    Google Scholar 

  34. Cunha-Gomes D, Kavarana NM, Choudhari C, Rajendraprasad JS, Bhathena HM, Desai PB et al (2003) Total oral reconstruction for cancers associated with advanced oral submucous fibrosis. Ann Plast Surg 51(3):283–289

    Article  PubMed  Google Scholar 

  35. Janjua OS, Bukhari SGA, Ibrahim MW, Mehmood S, Sarfraz T (2011) Oral submucous fibrosis—reconstruction with nasolabial flap. Pak Armed Forces Med J 2:1–3

    Google Scholar 

  36. Patel SG, Deshmukh S, Savant DN (1994) Squamous cell carcinoma arising in a nasolabial flap used in the treatment of oral submucous fibrosis. Br J Plast Surg 47:388–389

    Article  CAS  PubMed  Google Scholar 

  37. Kavarana NM, Bhathena HM, Griffiths RW (1989) Surgery for severe trismus in submucous fibrosis. Plast Reconstr Surg 83:401–403

    Article  Google Scholar 

  38. Agrawal M, Gupta DK, Tiwari AD (2011) Extended nasolabial flaps in the treatment of oral submucous fibrosis. J Oral Maxillofac Surg 10(3):216–219

    Article  Google Scholar 

  39. Tauro DP (2009) A unique melolabial flap in the surgical management of oral submucous fibrosis—“the sea gull flap”—an experience with 85 cases. A clinical study. Int J Oral Maxillofac Surg 38:508–512

    Article  Google Scholar 

  40. Kshirsagar R, Chugh A, Rai A (2010) Bilateral inferiorly based nasolabial flaps for the management of advanced oral submucous fibrosis. J Maxillofac Oral Surg 9:22–26

    Article  PubMed Central  PubMed  Google Scholar 

  41. Le PV, Gornitsky M (1996) Oral stent as treatment adjunct for oral submucous fibrosis. Oral Med Pathol Oral Radiol Endodontol 88:148–150

    Article  Google Scholar 

  42. Mahajan AD, Tatu RJ, Shenoy NA, Sharma VS (2010) Surgical management of oral submucous fibrosis in an edentulous patient. A procedural challenge. Natl J Maxillofac Surg 1:161–163

    Article  PubMed Central  PubMed  Google Scholar 

  43. Patil PG, Parkhedkar RD (2009) New graft-stabilizing clip as a treatment adjunct for oral submucous fibrosis. J Prosthet Dent 102(3):191–192

    Article  PubMed  Google Scholar 

  44. Mokal NJ, Raje RS, Ranade SV, Rajendra Prasad JS, Thatte RL (2006) Release of oral submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft—a new technique. Br J Plast Surg 58:1055–1060

    Article  Google Scholar 

  45. Wei FC, Chang YM, Kildal M, Tsang WS, Chen HC (2001) Bilateral small radial forearm flaps for the reconstruction of buccal mucosa after surgical release of submucosal fibrosis: a new, reliable approach. Plast Reconstr Surg 107:1679–1683

    Article  CAS  PubMed  Google Scholar 

  46. Celik N, Wei F-C, Chang Y-M, Yang W, Chen D-J, Tsai C-Y (2002) Squamous cell carcinoma of the oral mucosa after release of submucous fibrosis and bilateral small radial forearm flap reconstruction. Plast Reconstr Surg 110:34–38

    Article  PubMed  Google Scholar 

  47. Lee J-T, Cheng LF, Chen P-R, Wang C-H, Hsu H, Chien SH et al (2007) Bipaddled radial forearm flap for the reconstruction of bilateral buccal defects in oral submucous fibrosis. Int J Oral Maxillofac Surg 36(7):615–619

    Article  PubMed  Google Scholar 

  48. Tsao C-K, Wei F-C, Chang Y-M, Cheng M-H, Chuang DC-C, Kao H-K (2009) Reconstruction of the buccal mucosa following release for oral submucous fibrosis using two radial forearm flaps from a single donor site. J Plast Reconstr Aesthet Surg. doi:10.1016/j.bjps.2009.05.047

    Google Scholar 

  49. Lee J-T, Cheng L-F, Wang C-H, Hsu H, Chen P-R, Lin C-M (2006) A double-skin paddle radial forearm flap for the reconstruction of oral submucous fibrosis. Tzu Chi Med J 18:362–369

    Google Scholar 

  50. Chen C-M, Yang C-F, Shen Y-S, Huang I-Y, Wu C-F (2008) The use of artificial dermis for surgical defects in the treatment of oral premalignant lesions. J Surg Oncol 97:291–293

    Article  PubMed  Google Scholar 

  51. Jiang C-H, Li C, Shi F-Q, Chen X-Q, Tang Z-G, Jian X-C (2011) Clinical application of heterogeneous acellular dermal matrix in the surgical treatment of oral submucous fibrosis. Shanghai Kou Qiang Yi Xue 20:273–277

    PubMed  Google Scholar 

  52. Ko EC, Shen Y-H, Yang C-F, Huang I-Y, Shieh T-Y, Chen C-M (2009) Artificial dermis as the substitute for split-thickness skin graft in the treatment of oral submucous fibrosis. J Craniofac Surg 20:443–445

    Article  PubMed  Google Scholar 

  53. Huang J-J, Wallace C, Lin J-Y, Tsao C-K, Huang W-C, Cheng M-S (2009) Two small flaps from one anterolateral thigh donor site for bilateral buccal mucosa reconstruction after release of submucous fibrosis and/or contracture. J Plast Reconstr Aesthet Surg. doi:10.1016/j.bjps.2008.12.010

    Google Scholar 

  54. Huang I-Y, Wu C-F, Shen Y-S, Yang C-F, Shieh T-Y, Hsu H-J, Chen C-H (2008) Importance of patient’s co-operation in surgical treatment of oral submusous fibrosis. J Oral Maxillofac Surg 66:699–703

    Article  PubMed  Google Scholar 

  55. Gupta D, Sharma C (1988) Oral submucous fibrosis—A new treatment regimen. J Oral Maxillofac Surg 46(10):830–833

    Article  CAS  PubMed  Google Scholar 

  56. Manjunath KS, Uttakarsh L, Lokesh B, Desai V (2011) Surgical management of oral submucous fibrosis. Our perspective and literature review and various options for surgical reconstruction. J Pearldent 2:97–100

    Google Scholar 

  57. Paramhans D, Mathur RK, Newaskar V, Shukla S, Sudrania MK (2010) Role of collagen membrane for reconstruction of buccal defects following fibrotic band excision and coronoidectomy in oral submucous fibrosis. World Artic Ear Nose Throat 3:1–3

    Google Scholar 

  58. Morawetz G, Katsikeris N, Weinberg S, Listrom R (1987) Oral submucous fibrosis. Int J Oral Maxillofac Surg 16:609–614

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

No conflict of interest declared in the preparation and content of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Venkatesh V. Kamath.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kamath, V.V. Surgical Interventions in Oral Submucous Fibrosis: A Systematic Analysis of the Literature. J. Maxillofac. Oral Surg. 14, 521–531 (2015). https://doi.org/10.1007/s12663-014-0639-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-014-0639-3

Keywords

Navigation