The Oral Submucous Fibrosis is a condition more common in India and the Eastern Asia where the main cause is chewing of Areca Nuts, and many a times the ignorance leads to prolonged stages and as this is a pre-cancerous condition, several of these cases lead to cancer in the mouth. The medical management of Oral Submucous Fibrosis depends on the severity of the disease and the progression, and majorly the factors that led for it to occur.
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Oral Submucous Fibrosis Treatment
For the early treatment of OSMF, the cessation of the habit of areca nuts of the underlying cause is necessary, and from there, based on the condition, the different medical and surgical treatment options are considered. The treatment strategies include the below ones:
Steroids
Weekly submucosal intralesional injections or topical application of steroids may help prevent further damage, when the condition is in a moderate stage.
Hyaluronidase
It has to be used topically, and usage of this has shown the improving symptoms than when just administering the steroids. It can be added with steroids when given in intralesional steroid injections. The combination of both has proven to be more effective and give long-term results when compared to each separately.
Placental extracts (Placentrex)
The main reason for this is the anti-inflammatory effect of the Placental extracts, which are known to inhibit the further mucosal damage on the tissues, and thus helps in cessation of the disease. There is a marked improvement in the condition when the habit of the cause (Areca Nut) was stopped and subsequently there was a regular administration of the healthy human placental extracts in the affected tissues.
Lycopene
In the patients with Oral Submucous Fibrosis, there was a good recovering effect seen when the patients were given a daily oral dosage of 16mg of Lycopene. Along with this, intralesional injection of betamethasone is said to have given enhanced results, but the onset for this was late.
Pentoxifylline
There was a pilot study conducted, and in that 14 test subjects having the advanced stage of Oral Submucous Fibrosis were administered with pentoxifylline at 400 mg 3 times daily, and were compared to 15 age- and sex-matched diseased control subjects. There was a good improvement seen in the various factors of the disease, like the mouth opening, tongue protrusion and relief from fibrotic bands. Even the subjective symptoms from the patient got improved, and there was less irritation to spices, less burning sensation of the mouth and less difficulty in swallowing.
Although all these drugs have been proved quite effective in treating the OSF, the U.S. Food and Drug Administration has not yet approved these drugs for usage and treatment of this disease.
Surgical Treatment of Oral Submucous Fibrosis
At a stage where no direct medical treatment would work, and there is severe trismus, and if the radiological evidence shows neoplastic changes, one has to get surgical treatment done for the OSF. Here are the different options.
- Fibrous bands excision – The simple excision of the fibrous bands would result in the contracture of the tissues and upon healing, the fibrosis effect is lessened.
- Split-thickness skin grafting
Source: emedicine.medscape.com