Utility of Platysma Myocutaneous Flap and Extended Nasolabial Flap in the Surgical Management of Oral Submucous Fibrosis - A Prospective Study.

Abstract

Introduction: The study was carried out to compare platysma myocutaneous flap and extended nasolabial flap in terms of post-operative mouth opening, duration of surgery and complications associated with it in the surgical management of oral submucous fibrosis (OSMF).

Materials and methods: Patients diagnosed with OSMF (Grade III and IV OSMF according to Khanna and Andrade classification) were included in the study. Thirty patients were selected for the study, out of which 15 patients underwent reconstruction of surgical defects with platysma myocutaneous flap (Group I), and other 15 patients underwent reconstruction with extended nasolabial flap (Group II) post fibrotomy. Pre-operative and post-operative mouth opening, duration of surgery and other complications associated with both procedures were recorded. Postoperatively, patients were evaluated at the end of 1^st week, 3 months and 6 months.

Results: The results were analysed using an Unpaired t-test and Chi-square test. The mean pre-operative interincisal mouth opening in both the groups i.e., Group I was 11.8 mm and Group II was 9.82 mm. It was significantly improved to a mean of 31.9 mm in Group I and 33.87 mm in Group II postoperatively at 6 months of follow-up. However, no significant difference in mouth opening was observed between the groups preoperatively and postoperatively. The mean duration of surgery in Group I was 119.66 ± 12.60 min and was found to be significantly higher than in Group II, which was 102.33 ± 8.83 min. Extraoral scarring was present in both groups. Intraoral hair growth was observed in almost all the male patients in Group II. Transient marginal mandibular nerve injury was reported in four patients (26.6%) in Group II.

Discussion: Both the platysma myocutaneous flap and the extended nasolabial flap serve as a versatile flap in the surgical management of OSMF. However, in young patients, platysma myocutaneous flap can be preferred as scar is present on the collar region as compared to facial scar in the nasolabial flap.