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Article: Free flap reconstruction after surgical release of oral submucous fibrosis: Long-term maintenance and its clinical implications

TitleFree flap reconstruction after surgical release of oral submucous fibrosis: Long-term maintenance and its clinical implications
Authors
KeywordsOral submucous fibrosis
Malignant transformation
Submucous fibrosis
Release
Oral cancer
Issue Date2014
Citation
Journal of Plastic, Reconstructive and Aesthetic Surgery, 2014, v. 67, n. 3, p. 344-349 How to Cite?
AbstractBackground and aim Oral submucous fibrosis (OSF) is an insidious disease with progressive limitation of mouth opening and potential malignant change of the oral mucosa. Cancer surveillance is of utmost importance, but it is often limited by severe trismus. Surgical release and free flap reconstruction is effective but its long-term efficacy has not been completely established. This work aims to review our experience in the past 15 years in surgical release of OSF-related trismus followed by free flap reconstruction. Methods Patient's age, gender, smoking history, drinking history and betel-nut consumption history were retrieved. Surgical release and reconstructive procedures were detailed. Inter-incisor distances (IIDs) were measured preoperatively (PO-IID), intra-operatively after maximal release (IO-IID) and during the last follow-up (FU-IID). Subsequent development of oral cancers (oral squamous cell carcinoma, OSCC) and relevant details were documented. Potential predictors of long-term IID gain were analysed. Results A total of 92 patients were included in our study. There was a significant difference (p = 0.000) in PO-IID (13.8 ± 6.6 mm) and FU-IID (27.2 ± 8.8 mm) indicating the long-term efficacy of the release procedure. The mean long-term IID gain was 13.0 ± 7.5 mm. Bilateral coronoidectomy resulted in a greater degree of intra-operative gain in IID (p = 0.025). PO-IID (r = -0.277, p = 0.001) and intra-operative gain in IID (r = 0.198, p = 0.001) were found to be predictive of long-term IID gain. Ten patients (11%) developed OSCC during our study period. Conclusions Aggressive surgical release (with bilateral coronoidectomy if necessary) followed by free flap reconstruction is an effective treatment for OSF-related trismus. Our study has confirmed its long-term efficacy and its important role in cancer surveillance.
Persistent Identifierhttp://hdl.handle.net/10722/230949
ISSN
2015 Impact Factor: 1.743
2015 SCImago Journal Rankings: 0.974

 

DC FieldValueLanguage
dc.contributor.authorChan, Richie Chiu Lung-
dc.contributor.authorWei, Fu Chan-
dc.contributor.authorTsao, Chung Kan-
dc.contributor.authorKao, Huang Kai-
dc.contributor.authorChang, Yang Ming-
dc.contributor.authorTsai, Chi Ying-
dc.contributor.authorChen, Wen Ho-
dc.date.accessioned2016-09-01T06:07:14Z-
dc.date.available2016-09-01T06:07:14Z-
dc.date.issued2014-
dc.identifier.citationJournal of Plastic, Reconstructive and Aesthetic Surgery, 2014, v. 67, n. 3, p. 344-349-
dc.identifier.issn1748-6815-
dc.identifier.urihttp://hdl.handle.net/10722/230949-
dc.description.abstractBackground and aim Oral submucous fibrosis (OSF) is an insidious disease with progressive limitation of mouth opening and potential malignant change of the oral mucosa. Cancer surveillance is of utmost importance, but it is often limited by severe trismus. Surgical release and free flap reconstruction is effective but its long-term efficacy has not been completely established. This work aims to review our experience in the past 15 years in surgical release of OSF-related trismus followed by free flap reconstruction. Methods Patient's age, gender, smoking history, drinking history and betel-nut consumption history were retrieved. Surgical release and reconstructive procedures were detailed. Inter-incisor distances (IIDs) were measured preoperatively (PO-IID), intra-operatively after maximal release (IO-IID) and during the last follow-up (FU-IID). Subsequent development of oral cancers (oral squamous cell carcinoma, OSCC) and relevant details were documented. Potential predictors of long-term IID gain were analysed. Results A total of 92 patients were included in our study. There was a significant difference (p = 0.000) in PO-IID (13.8 ± 6.6 mm) and FU-IID (27.2 ± 8.8 mm) indicating the long-term efficacy of the release procedure. The mean long-term IID gain was 13.0 ± 7.5 mm. Bilateral coronoidectomy resulted in a greater degree of intra-operative gain in IID (p = 0.025). PO-IID (r = -0.277, p = 0.001) and intra-operative gain in IID (r = 0.198, p = 0.001) were found to be predictive of long-term IID gain. Ten patients (11%) developed OSCC during our study period. Conclusions Aggressive surgical release (with bilateral coronoidectomy if necessary) followed by free flap reconstruction is an effective treatment for OSF-related trismus. Our study has confirmed its long-term efficacy and its important role in cancer surveillance.-
dc.languageeng-
dc.relation.ispartofJournal of Plastic, Reconstructive and Aesthetic Surgery-
dc.subjectOral submucous fibrosis-
dc.subjectMalignant transformation-
dc.subjectSubmucous fibrosis-
dc.subjectRelease-
dc.subjectOral cancer-
dc.titleFree flap reconstruction after surgical release of oral submucous fibrosis: Long-term maintenance and its clinical implications-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.bjps.2013.12.004-
dc.identifier.pmid24530059-
dc.identifier.scopuseid_2-s2.0-84896714805-
dc.identifier.volume67-
dc.identifier.issue3-
dc.identifier.spage344-
dc.identifier.epage349-
dc.identifier.eissn1878-0539-

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