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Efficacy of nasolabial flap in reconstruction of fibrotomy defect in surgical management of oral submucous fibrosis: a prospective study

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Abstract

Purpose

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.

Material and method

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.

Results

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.

Conclusion

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.

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References

  1. Pindborg JJ, Sirsat SM (1966) Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol 22:764–779

    Article  CAS  PubMed  Google Scholar 

  2. Sirsat SM, Khanolkar VR (1962) Submucous fibrosis of the palate and pillars of the fauces. J Med Sci 16:189–197

    CAS  Google Scholar 

  3. Paymaster JC (1956) Cancer of buccal mucosa; a clinical study of 650 cases in Indian patients. Cancer 9(3):431–435

    Article  CAS  PubMed  Google Scholar 

  4. Gupta MK, Mhaske S, Ragavendra R, Imtiyaz (2008) Oral submucous fibrosis—current concepts in etiopathogenesis. Peoples J Sci Res 1:39–44

  5. Lambade P, Dawane P, Thorat P (2014) Oral submucous fibrosis—a treatment protocol based on clinical study of 100 patients in central India. J Oral Maxillofac Surg. doi:10.1007/s10006-014-0478-x

    Google Scholar 

  6. Arakeri G, Peter A, Brennan PA (2013) Oral submucous fibrosis: an overview of the etiology, pathogenesis, classification and principles of management. BJOMS 51:587–593

    Google Scholar 

  7. Borle RM, Borle SR (1991) Management of oral submucous fibrosis conservative approach. J Oral Maxillofac Surg 49:788–791

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  9. Petruzzelis GS, Johnson JT, Myers EN (1992) Histomorphic analysis of intraoral split-thickness skin graft. J Head Neck 14(2):119–124

    Article  Google Scholar 

  10. Hofstra E I, Hofer M S O P, Nauta J M. et al. Oral function outcome after intraoral reconstruction with nasolabial flap. The Bri Assoc Plast Surg 2004; 57: 150–155

    Article  CAS  Google Scholar 

  11. Tan N-C, Hsieh C-H, Riva FMG, Jeng S-F (2013) The nasolabial flap as a one-stage procedure for reconstruction of intermediate-to-large lip defects with functional and aesthetic assessments. J Plast Reconstr Aesthet Surg 66:352–357

    Article  PubMed  Google Scholar 

  12. Jiang X, Jing H (2009) Drug treatment of oral submucous fibrosis: a review of literature. J Oral Maxillofac Surg 67:1510–1515

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  14. Gupta D, Sharma SC (1988) Oral submucous fibrosis—a new treatment regimen. J Oral Maxillofac Surg 46:830–833

    Article  CAS  PubMed  Google Scholar 

  15. Desa JV (1957) Submucous fibrosis of the palate and cheek. Ann Otol Rhinol Laryngol 66:1143–1145

    CAS  PubMed  Google Scholar 

  16. Yen DJC (1982) Surgical treatment of submucous fibrosis. J Oral Surg:270–272

  17. 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 

  18. 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 Endod 107:1–10

    Article  Google Scholar 

  19. Mokal NJ, Raje RS, Ranade SV, Rajendra Prasad JS, Thatte RL (2005) . 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  CAS  PubMed  Google Scholar 

  20. 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 

  21. Huang JJ, Wallace C, Lin JY, Tsao CK, Kao HK, Huang WC, Cheng M, Wei F (2010) Two small flaps from one antero-lateral thigh donor site for bilateral buccal mucosa reconstruction after release of submucous fibrosis and/or contracture. J Plast Reconstr Aesthet Surg 63:440–445

    Article  PubMed  Google Scholar 

  22. Golhar S, Mahore MN, Narkhede S (1989) Tongue flaps in oral submucous fibrosis. Indian J Otolaryngol 41(3):272–276

    Google Scholar 

  23. Schmidt BL, Dierks EJ (2003) The nasolabial flap. Oral Maxillofac Surg Clin N Am 15:487–495

    Article  Google Scholar 

  24. Ducic Y, Burye M (2000) Nasolabial flap reconstruction of oral cavity defects: a report of 18 cases. J Oral Maxillofac Surg 58:1104–1108

    Article  CAS  PubMed  Google Scholar 

  25. Nikolaos L et al (1998) The inferiorly and superiorly based nasolabial flap for the reconstruction of moderate-sized oronasal defects. J Oral Maxillofac Surg 56:1255–1259

    Article  Google Scholar 

  26. Sohn WI, Choi JY, Seo BF, Jung SN (2012) Reconstruction of nasal ala with nasolabial perforator flap after cancer removal. Head Neck Oncol 4(4):83

    Google Scholar 

  27. Harry Wright, Scott Stephan, James Netterville. Nasolabial flap for oral cavity reconstruction. Atlas of otolaryngology, head & neck operative surgery

  28. Kavarana NM, Bathena HM (1987) Surgery for severe trismus in submucous fibrosis. Br J PlastSurg 40:407–409

    Article  CAS  Google Scholar 

  29. Schultz TA (2014) Basic flap design. Oral Maxillofacial Surg Clin North Am 26:277–303

    Article  Google Scholar 

  30. Kshirsagar R, Chugh A, et al (2009) Bilateral inferiorly based nasolabial flaps for the management of advanced oral submucous fibrosis. J Oral Maxillofac Surg 1:22–26

    Google Scholar 

  31. Mariya A, Sharma Y, Kour P (2011) Use of nasolabial flap in the management of oral submucous fibrosis—a clinical study. Peoples J Sci Res 4:1–2830

    Google Scholar 

  32. Huang I-Y, Fung C, Shyyongshen Y, et al. (2008) Importance of patient’s co-operation in surgical treatment for oral submucous fibrosis. J Oral Maxillofac Surg 66:699–703

    Article  PubMed  Google Scholar 

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Correspondence to Pravin Lambade.

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Lambade, P., Meshram, V., Thorat, P. et al. Efficacy of nasolabial flap in reconstruction of fibrotomy defect in surgical management of oral submucous fibrosis: a prospective study. Oral Maxillofac Surg 20, 45–50 (2016). https://doi.org/10.1007/s10006-015-0519-0

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  • DOI: https://doi.org/10.1007/s10006-015-0519-0

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