Clinical evaluation of different treatment methods for OSMF: A five-year experience with 144 cases

Introduction: Oral submucous fibrosis (OSMF) is chronic, insidious, debilitating condition of oral cavity and sometimes pharynx, characterized by progressive hyalinization of juxtaepithelial tissue and progressive fibrosis of the oral cavity. It is a premalignant disease. The repeated ulceration in mouth and the progressive reduction of mouth opening is very debilitating to the patient. The disease once occurs does not reverse. None of the modalities provide the complete remission of the disease and are aimed at improving the functions of the mouth like chewing and opening of mouth. Aims and Objectives: The aim of this study is to establish a treatment protocol for OSMF depending on the stage of the disease. As the disease has multiple stages, a single treatment modality is not adequate for the treatment. The treatment has to be devised according to the symptoms of the patient and the stage of the disease. Materials and Methods: It is a retrospective study done on 144 patients who are followed up for six months. The treatment was done depending on the stage of disease and the outcomes were evaluated. Results: The cessation of the arecanut chewing habits and regular physiotherapy is a single most important factor for the success of treatment. Noninvasive treatment methods give good results with patient in stage I and Stage II disease. In our institute, single stage pedicled nasolabial flap worked well for the patients in stage III and Stage IV disease. The good mouth opening was achieved even in patients with mouth opening less than 5mm. Conclusion: The proposed protocol is very effective in treating patients with OSMF. The medicinal treatment is effective in patients with mouth opening more than 20 mm. It helps in the resolution of symptoms and improvement of mouth opening. However, in severe cases with mouth opening less then 20mm, surgical treatment is required. Among the surgical treatments used by us single stage pedicled nasolabial flap gave the best results.