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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
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated