Category: Oral Submucous Fibrosis

Improved mouth-opening following facial reconstructive surgery for Oral Submucous Fibrosis

2/3/2015

Below is the case of a patient posted earlier who was afflicted with oral submucous fibrosis. He had severely restricted mouth-opening. Maxillofacial surgeon Dr. S.M. Balaji successfully performed the facial reconstruction surgery to improve his mouth-opening.

http://blog.smbalaji.com/surgery-of-the-week/oral-submucous-fibrosis

We are updating the post with recent postoperative photograph showing increased mouth opening following few weeks after surgery. The patient is very happy that he is able to open his mouth easily and normally.

Severely limited mouth opening before surgery

Fibrous bands released on left & right cheek to improve mouth opening

Nasolabial island flap based on facial artery raised & transposed intraorally on both sides

Flaps sutured with the buccal mucosal defect on right & left side

Following surgery, normal mouth opening achieved with minimal scarring

Postoperative view showing increased mouth opening and enhanced healing following few weeks after surgery

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Surgical treatment for Oral Submucous Fibrosis

20/2/2015

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A 30-year-old man came to our hospital seeking treatment for his inability to open his mouth normally. Preoperatively, his mouth opening was just 11 mm. He gave a history of cigarette smoking and pan chewing for 2 decades. He was diagnosed with Oral submucous fibrosis, a condition characterized by thickening of the mucosal tissues and progressive rigidity of the jaws making it exceedingly difficult to open the mouth.

In the surgical treatment procedure, Maxillofacial Surgeon Dr. S.M. Balaji placed transverse incisions on the cheek on both right & left side to release the fibrous bands and to immediately improve the mouth opening. An inferiorly based Nasolabial island flap based on the facial artery was raised and transposed intraorally through a small trans-buccal tunnel. This was sutured with the buccal mucosal defect. Extraorally, the defect was closed in layers. Immediately following surgery, a normal mouth opening of 32 mm was achieved.

Preoperative reduced mouth opening

Nasolabial flap raised to reconstruct the affected portion of buccal mucosa

Nasolabial flap rotated and fixed in the defective portion of buccal mucosa

Immediately after surgery

Increased mouth opening following surgery

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Miracle protein rhBMP-2 for alveolar cleft closure avoiding bone grafting

20/10/2014

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A 5-year-old girl from Kerala, born with bilateral cleft lip and palate reported to our hospital seeking specialized correction for her cleft defect in the upper alveolar bone (teeth bearing region of jaw). She was previously operated for cleft lip & cleft palate.

Due to the bilateral cleft defect, the child’s upper jaw bone was in 3 parts. Maxillofacial Surgeon Dr. S.M. Balaji employed an advanced technology to close the alveolar cleft. Collagen sponge soaked in miracle protein rhBMP-2 was placed in the cleft site which stimulates the body’s own cells to rapidly form new bone thereby joining the 3 segments into a single complete bone. With this, a second surgery for bone graft and unsightly scarring at the graft site is avoided. Dr. Balaji has successfully used this novel protein in complete reconstruction of several facial bone defects.

Preoperative intraoral view showing cleft separating premaxilla from the alveolus

3D CBCT scan showing detached and forwardly placed premaxilla from rest of the alveolus

During procedure premaxillary segement was mobilized and the cleft alveolus was exposed

Miracle protein rhBMP-2 was placed in the alveolar cleft defect to induce new bone formation

Gingivomucoperiosteal flap was sutured and the cleft defect was completely sealed with BMP protein

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Oral Submucous Fibrosis

11/3/2014

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A 32-year-old man came to our hospital seeking treatment for his extreme inability to open his mouth normally. Preoperatively, his mouth opening was just 11 mm. He gave a history of cigarette smoking and pan chewing for 2 decades. He was diagnosed with Oral submucous fibrosis, a condition characterized by thickening of the mucosal tissues and progressive rigidity of the jaws making it exceedingly difficult to open the mouth. Previously he underwent laser surgery elsewhere, 3 times, for this ailment but it did not work.

In the surgical treatment procedure, Maxillofacial Surgeon Dr. S.M. Balaji placed transverse incisions on the cheek on both right & left side to release the fibrous bands and to immediately improve the mouth opening. An inferiorly based Nasolabial island flap based on the facial artery was raised and transposed intraorally through a small trans-buccal tunnel. This was sutured with the buccal mucosal defect. Extraorally, the defect was closed in layers. Immediately following surgery, a normal mouth opening of 35 mm was achieved.

Severely limited mouth opening before surgery

Fibrous bands released on left & right cheek to improve mouth opening

Nasolabial island flap based on facial artery raised & transposed intraorally on both sides

Flaps sutured with the buccal mucosal defect on right & left side

Following surgery, normal mouth opening achieved with minimal scarring

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Improved mouth-opening following facial reconstructive surgery for Oral Submucous Fibrosis

Surgical treatment for Oral Submucous Fibrosis

Miracle protein rhBMP-2 for alveolar cleft closure avoiding bone grafting

Oral Submucous Fibrosis

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