European Journal of Biomedical and Pharmaceutical Sciences

MANAGEMENT OF POST RADIATION MICROSTOMIA - A CASE REPORT

*Dr. Swaminathan C., B.D.S, M.D.S, Dr. Mathew Jose BDS, MDS, Dr. Dineksh Kumar, BDS, MDS, Dr. Shameem Jamal BDS, MDS

ABSTRACT

Oral submucous fibrosis is a chronic debilitating condition of the mouth caused by areca nut chewing. It is a precancerous condition with malignant transformation rate of 7-30%. The management of malignant lesion arising from this precancerous condition is debatable as the surgery alone protocol doesnot prevent the occurrence of second primaries or recurrences and the standard surgery followed by radiation protocol results in further fibrosis resulting in trismus and microstomia The causative factors are trauma, infection, drug induced (succinyl choline), neoplasm, Oral submucous fibrosis, Post radiation fibrosis. Microstomia and Trismus are two different term with varied definition. Microstomia is defined as reduced oral aperture due to various etiologies. The causative factors are Physical trauma to masticatory muscles, chemical burns, electric burns, post surgery, post radiotherapy, scleroderma and syndromes like Freeman-Sheldon syndrome, Leopard syndrome, Moebius syndrome. Diagnosis of Microstomia is not defined by specific criteria and the diagnosis depend on functional efficiency and esthetics. Trismus is defined as mouth opening restriction (the maximum interincisal distance is <35mm) due to masticatory muscle spasm. The reason behind all extra articular trismus is fibrotic contracture of soft tissue of check and masticatory muscles. Both Microstomia and trismus drastically affect the quality of life. Treatment of extra articular trismus is by topical or systemic drugs, surgery and physiotherapy. Here we report a case of post radiation fibrosis which caused microstomia, trismus and which was treated by combined medical therapy and surgical correction followed by physiotherapy.

Keywords: Trismus and microstomia.