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Indian J Dent Res. 2019 May-Jun;30(3):472-477. doi: 10.4103/ijdr.IJDR_423_17.

Recurrent oral submucous fibrosis with nil mouth opening surgical management and reconstruction with bilateral nasolabial flap: A case report and review of literature.

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International Medical Center, Jeddah, Saudi Arabia; Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, Chennai, Tamil Nadu, India.


Oral submucous fibrosis [OSF] is a premalignant condition characterized by inflammation and progressive fibrosis of submucosal tissue, resulting in trismus. It is associated with chewing of areca nut in betel quid. Mortality rate is significant because it transforms into oral squamous cell carcinoma at a rate of 2.3%-7.6%. The aim of this article is to share our experience in managing a case of recurrent oral submucous fibrosis with nil mouth opening by surgical excision, coronoidotomy, and reconstruction of buccal defect using bilateral inferiorly based nasolabial flap, followed by active oral physiotherapy. The patient had reached an acceptable mouth opening with no further recurrence. The patient was observed closely for any malignant transformation. Surgical excision of bands and coronoidotomy followed by reconstruction with nasolabial flaps and active physiotherapy in the postoperative period remains a good option for recurrent and advanced cases of OSF with acceptable functional and cosmetic results.


Nasolabial flaps; nil mouth opening; recurrent oral submucous fibrosis; squamous cell carcinoma; surgical excision

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