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Free flap reconstruction after surgical release of oral submucous fibrosis: long-term maintenance and its clinical implications.
[oral submucous fibrosis]
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
.
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
.
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
.
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
.
Diseases
Validation
Diseases presenting
"oscc"
symptom
oral submucous fibrosis
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