Is buccal fat pad a better option than nasolabial flap for reconstruction of intraoral defects after surgical release of fibrous bands in patients with oral submucous fibrosis? A pilot study: A protocol for the management of oral submucous fibrosis

Purpose: The aim this study was to compare the buccal fat pad (BFP) and nasolabial flap for reconstruction of intraoral defects after release of fibrous bands in patients with oral submucous fibrosis (OSF). Materials and methods: This is a comparative study. The study sample was derived from the population of patients who presented, with restricted mouth opening of less than 20 mm, to the Department of Oral and Maxillofacial Surgery, Swargiya Dada Saheb Kalmegh Dental College and Hospital Hingna Nagpur. The patients were divided into two groups. In Group I (n = 10) reconstruction was performed with a nasolabial flap and in Group II (n = 10) with BFP. Both groups were analysed separately for mouth opening (interincisal distance in millimetres) preoperatively and 20 months postoperatively, time taken for epithelialization of BFP and nasolabial flaps. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Inc, Chicago, IL) using the _2 test and Student's t test. Results: In all 20 patients the interincisal mouth opening was (mean) 11 mm (3-19 mm) preoperatively which improved to a mean of 42 mm (23-52 mm). In Group I there were more complications as compared to Group II such as partial flap necrosis particularly at the tips, temporary widening of oral commissure and subluxation of TMJ. The unsightly extraoral scar and intraoral growth of hairs were not seen in Group II. Conclusion: BFP is the better choice for reconstruction in comparison to nasolabial flap. (C) 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.