Oral Submucous Fibrosis and Elongated Styloid Process - Do they have an Alarming Inter-Connection?

<p class="abstract">Oral submucous fibrosis is a widespread, premalignant disorder causing severe difficulty in mastication and speech. With high rate of malignant conversion, it demands aggressive surgical therapy followed by mandatory long-term physiotherapy. An elongated styloid process, if present, could pose a strong hindrance to movement of mandible, leading to complete relapse of trismus in such cases. The purpose of this report is to elaborate on such co-existence in patients having oral submucous fibrosis using digital orthopantomogram. 3 patients suspected to have an elongated styloid process were referred to maxillofacial surgical unit and diagnosed with grade 4A oral submucous fibrosis. Digital orthopantomogram revealed elongated styloid process which was measured using the C. S. imaging software 7.0.3. Consequently, patients were operated by a team of maxillofacial surgeons and otolaryngologists to relieve trismus and tonsillo-styloidectomy respectively. The measured lengths of the styloid process on digital orthopantomogram were considered elongated, if exceeding the normal length of 30 mm. The measured lengths of the styloid process were found to be at 52.7 mm, 50.1 mm and 57 mm on the right side and 51 mm, 46.8 mm and 37 mm on left side respectively in our cases. These elongated styloid processes observed in all three cases of submucous fibrosis indicates that progressive fibrosis may exert significant influence on the ossification of styloid complex. Hence, a routine preoperative screening in all patients of oral submucous fibrosis is imminent to avoid postoperative failure, pain or discomfort to the patient owing to an elongated styloid process. </p>

Download Full-text

Varied presentations of a mineralized styloid process in oral submucous fibrosis patients visualized on digital panoramic radiographs

IP International Journal of Maxillofacial Imaging ◽

10.18231/j.ijmi.2021.013 ◽

2021 ◽

Vol 7 (2) ◽

pp. 67-73

Author(s):

Shital Patel ◽

Deval Mehta ◽

Taher Rupawala ◽

Nimesh Patel ◽

Kruna Bhimani ◽

...

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Styloid Process ◽

Panoramic Radiographs ◽

Elongated Styloid Process ◽

The Past ◽

Premalignant Condition ◽

Submucous Fibrosis ◽

Grade Iii

Oral Submucous Fibrosis (OSMF) is a widely prevalent, premalignant condition which adversely affects the quality of life of an individual and can warrant stringent surgical regimen for its treatment. An Elongated Styloid Process (ESP), if coexisting, can invariably impair the post-surgical mandatory physiotherapy necessary to maintain the mouth-opening achieved intraoperatively. To evaluate digital Orthopantomograms (OPGs) of patients having OSMF and to observe presentations of various combinations of calcification types and patterns of ESP in them. Patients with clinically diagnosed OSMF (Grade III and IV according to Khanna and Andrade 1995) were advised a digital OPG to measure and observe the ESP using the C.S. Imaging Software 7.0.3.The digitized OPGs were converted into KODAK large format prints and then ESP was measured starting from the point where it is visualized to leave the tympanic plate extending upto its tip and its myriad of combinations of calcification patterns were recorded by a single observer.The presence of unilateral and bilateral elongation along with the type and pattern of calcification was effectively noted using the C.S. Imaging Software 7.0.3. Visualization of various unique, varying patterns of ESP was noted. Sixteen such different radiological presentations were shown, captured through digital OPGs. An undetected ESP can prove to be detrimental for a patient who is recently treated for OSMF as it hinders efficient postoperative mouth opening exercises. This can easily be prevented by a simple maneuver of identifying the ESP on a digital OPG using computer aided software. The presence of assorted radiographic patterns in patients having OSMF indicate that extensive research should be directed to identify and categorize such patterns which do not conform to the past methods of classification. This study hints towards the existence of a scope to study the factors responsible for the occurrence of the varied combinations of calcification and thickness of the ESP and their clinical relevance.

Download Full-text

Assessment Of Salivary Ph In Patients With Oral Submucous Fibrosis

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2020.12.04.425 ◽

2020 ◽

Vol 12 (04) ◽

Keyword(s):

Oral Submucous Fibrosis ◽

Salivary Ph ◽

Submucous Fibrosis

Download Full-text

Positive Feedback Loop of SNAIL-IL-6 Mediates Myofibroblastic Differentiation Activity in Buccual Mucosa Fibroblasts: Therapeutic Target for Oral Submucous Fibrosis

SSRN Electronic Journal ◽

10.2139/ssrn.3569822 ◽

2020 ◽

Author(s):

Chih-Yu Peng ◽

Pei-Ling Hsieh ◽

Yi-Wen Liao ◽

Cheng-Chia Yu

Keyword(s):

Positive Feedback ◽

Therapeutic Target ◽

Feedback Loop ◽

Oral Submucous Fibrosis ◽

Positive Feedback Loop ◽

Submucous Fibrosis ◽

Myofibroblastic Differentiation

Download Full-text

Comparative Study of Intralesional Dexamethasone Plus Hyaluronidase & Oral Colchicine in Patients with Oral Submucous Fibrosis

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v14i2.21542 ◽

2018 ◽

Vol 14 (2) ◽

pp. 60-65

Author(s):

Ganesh Prasad Neupane ◽

Maya Rai ◽

R. S. Rathore ◽

V. K. Bhargava ◽

A. K. Mahat ◽

...

Keyword(s):

Treatment Outcomes ◽

Oral Mucosa ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Study Groups ◽

T Test ◽

Significant Difference ◽

Intralesional Injections ◽

Submucous Fibrosis ◽

Larger Sample

Introduction: Oral Submucous Fibrosis (OSMF) is a precancerous condition of the oral mucosa. It is characterized by excessive production of collagen leading to inelasticity of the oral mucosa and atrophic changes of the epithelium.Aim and objective: To evaluate the efficacy of oral Colchicine in comparison to intralesional injections of Dexamethasone plus Hyaluronidase in the management of OSMF patients.Materials and Methods: Fourty patients with OSMF were randomly divided equally into two groups. 20 patients in Dexamethasone group received biweekly intralesional injections of Dexamethasone (4mg/ml) plus Hyaluronidase 1500 IU in buccal mucosa for a period of 12 weeks. Other 20 patients in Colchicine group received oral Colchicine 0.5 mg tablets twice daily for 12 weeks. Parameters taken in the study were burning sensation, and mouth opening. Descriptive statistics, paired t test and unpaired t test were used for statistical analysis.Results and Conclusions: The pre- and post-treatment differences were found to be statistically significant for both the groups (p<0.001) and for both the treatment outcomes. When the average difference of the treatment outcomes was compared between the two study groups, statistically highly significant difference was noted (p <0.001) only in mouth opening but not in burning sensation.These encouraging results should prompt further clinical trials with Colchicine on a larger sample size to broaden the therapeutic usefulness of the drug in the management of OSMF. JNGMC, Vol. 14 No. 2 December 2016, Page: 60-65

Download Full-text