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Suffering From Oral Submocous Fibrosis. Treated With Intralesional Triamcinolone. Done With Laser Treatment. Line Of Treatment?

Posted on Tue, 15 Oct 2013

Question: I am suffering from Oral Submocous Fibrosis for past several years without dysplastic change. I was chewing Pan masala and Tabacoo for around 25 years. Left chewing Pan masala and Tabacoo in 2008. At present my age is 56 years. From XXXXXXX 2010 I was treated with intralesional triamcinolone 10 mg every 3 to 4 weeks and Hychrosidane 1500 upto XXXXXXX 2013. Intially there was some improvement in mouth opening, but susequently no improvement has been noticed. Laser therapy done on 2nd July 2013, both side of the mouth in V shape. specially deeper in right side. mouth-opening improved further. But in the inside part of right cheek, a small portion did not heal after the laser treatment and has become harder. It has reduced in size but still the hardness pertains. In the morning time, mouth opening is less and there is more hardness in that portion. But after exercise, blowing of mouth and gargles, opening improves and the hardness reduces. As per my Dr.Dibendu Majumdar, who has done the laser at Kolkata has suggested that after the V shape, V to be lasered to Y shape by lasering the last band at the joint of the jaws in my mouth on both sides,mainly right side.

C- Reactive Protien test done on 18/09/2013 shows negative result. All other blood reports are normal.

Please advice that in such circumstances what medicine and line of treatment should I follow. please let us know which is the best possible treatment for this problem in the world and which doctor or hospital to consult. We would appreciate your guidance at the earliest.

Thank you.
XXXXXX

Contact details as below:
Ashray apartments, flat 4b
12 XXXXXXX park
Kolkata: 0000
India

Phone : +91 0000
Email: XXXXXXX @ WWW.WWWW.WW

Answered by Dr. Abhishek Sharma (44 minutes later)

Brief Answer:
Sublabial Flaps

Detailed Answer:
Hello XXXXXXX
Treatment of Submucous fibrosis is very difficult.
I would advice that Submucous fibrosis is reactionary thing ,which has happened because of excessive tobacco usage.
Now getting it operated by Laser ie traumatising it more will lead to more fibrosis.
There is only one treatment i feel is good which gives some relief, ie Sublabial flap surgery in which mucosal (inside skin of mouth) flaps are elevated from cheek and rotated and used to widen the oral cavity.
You have already tried Steroid therapy which gives little relief only.
Consult some Maxillofacial surgeon or plastic surgeon there and they might examine and suggest that what can be done next.
At least you must continue multivitamins , Lycopene etc. Take turmeric milk daily.Take lemon juice daily.chew chewing gums , not beetel nut.
These natural things do help and improve the mucosal immunity.
In doubt do reply
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Abhishek Sharma (1 hour later)

Hello Doctor,

As I mentioned earlier that inside of right side chick a small potion has not heal after laser and become hard. What to do for the same.

Suggest good doctor or institute for check up and treatment . Please give you address and contact no.

Regards,

XXXXX

Answered by Dr. Abhishek Sharma (44 minutes later)

Brief Answer:
Contact ENT specialist

Detailed Answer:
hello,
If there is a ulcer as you said it has not healed , then you should contact an ENT specialist and get examined for the ulcer or the non healed area.
please do not take it lightly.Do consult a doctor
I stay in rajasthan, i will try to find out ENT specialist in Kolkata .
Regards

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D