Surgical Fibrolysis and Skin Grafts in the Management of Oral Submucous Fibrosis

Introduction: Oral submucous fibrosis (OSMF) is a chronic, insidious, irreversible disease characterized mainly by two symptoms, burning sensation in the mouth while eating spicy hot food in early stages of the disease and trismus in the late stages of the disease. Materials and Methods: This is retrospective hospital-based study of 25 patients, selected from 170 patients of OSMF, who attended OPD of Oral and Maxillofacial Surgical Hospital, Rajkot, Gujarat, India. Patients were selected for surgery based on their inter-incisal distance (IID) (Between 0.00 cm [Complete Trismus] and 2.5 cm). Patients having IID > 2.5 cm were not subjected to surgical treatment. Complete records of the patients were maintained, and patients were followed postoperatively for the period of at least 3 Years. Results: An average pre-operative IID of 25 patients who underwent surgery was found to be 1.49 cm, intra-operative IID was 2.86 cm while immediate post-operative IID was found to be 3.40 cm. All patients were recalled for check-up after 6 months, 1, 2, and 3 years in the post-operative period. The average IIDs recorded at the time of post-operative check-up were found to be as 6 months = 3.51 cm, 1-year IID = 3.45 cm, 2 years IID = 3.43 cm and 3 years IID was 3.44 cm. Thus, improvement in IID at pre-operative period (1.49 cm) was recorded to be (3.44 cm) at the end of 3-year period. Conclusions: Surgical excision of fibrous bands followed by application of split skin graft covering the raw area in buccal mucosa gives good long-term results without any complications and satisfactory long-term results.