Use of Pre and post treatment comparison of intra-lesional  infiltration of dexamethasone plus hyaluronidase in management of patients with OSMF.

Vijaya Bala  Murmu; Ragini  Kullu

doi:10.51168/sjhrafrica.v5i11.1771

Authors

Dr Vijaya Bala Murmu Senior Resident,ENT Shaheed Nirmal Mahato Medical College and Hospital, Dhanbad
Dr Ragini Kullu Senior Resident, Dept. of ENT, SBMCH, Hazaribagh

DOI:

https://doi.org/10.51168/sjhrafrica.v5i11.1771

Keywords:

Oral Submucous Fibrosis, Dexamethasone, Hyaluronidase, Intralesional therapy

Abstract

Background: Oral Submucous Fibrosis (OSMF) is a chronic, progressive, and potentially malignant disorder characterized by fibrosis of the oral mucosa, leading to trismus and burning sensation. Intralesional injections offer a localized approach to treatment with fewer systemic effects.

Aim: To evaluate and compare the pre- and post-treatment outcomes of intralesional dexamethasone and hyaluronidase in the management of OSMF.

Materials and Methods: A tertiary care centre conducted one-year prospective interventional research on 50 clinically confirmed OSMF patients. Each patient received biweekly intralesional dexamethasone (4 mg/mL) and hyaluronidase (1500 IU) injections for six weeks. Mucosal flexibility, mouth opening, and VAS were measured before and after therapy.

Results: There was a statistically significant increase in mean mouth opening (from 23.4 ± 4.1 mm to 31.2 ± 3.8 mm) and a marked reduction in VAS scores for burning sensation (from 7.3 ± 1.1 to 2.1 ± 0.9). Mucosal flexibility improved in 86% of patients.

Conclusion: Intralesional dexamethasone combined with hyaluronidase effectively improves clinical outcomes in OSMF patients, showing significant symptomatic and functional benefits.

References

Sirsat SM, Kher RK. Oral submucous fibrosis: its pathogenesis and management. J Oral Surg. 1973;31(8):241-247.

Gupta PC, Ray CS. Epidemiology of betel quid usage. Indian J Cancer. 2004;41(1):40-46.

Pindborg JJ, Sirsat SM. Oral submucous fibrosis. Cancer. 1966;19(5):919-926.

Sinha S, Saha S, Majumdar S. Pathogenesis of oral submucous fibrosis: a review. J Indian Acad Oral Med Radiol. 2013;25(2):118-122.

Rajendran R. Oral submucous fibrosis: etiology, pathogenesis, and future research. J Oral Maxillofac Pathol. 2011;15(2):132-137.

Anneroth G, Holmstrom S, Moller T. The malignant transformation of oral submucous fibrosis. Cancer. 1983;51(4):847-850.

Ranganathan K, Reddy PV, Sankari SL, et al. Oral submucous fibrosis: a review of etiology and pathogenesis. J Oral Maxillofac Pathol. 2013;17(1):51-56.

Desai H, Shukla A, Raval A, et al. The role of hyaluronidase in oral submucous fibrosis: a review. J Oral Health Comm Dent. 2013;7(1):44-47.

Bansal R, Verma S. Role of corticosteroids in the management of oral submucous fibrosis: a systematic review. J Dent Med Sci. 2015;14(1):75-79.

Kerr AR, Warnakulasuriya S. Oral submucous fibrosis: a review of the current management and possible directions for the future. Oral Health Dent Manag. 2014;13(2):254-258.

Khanna JN, Andrade NN. Oral submucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral Maxillofac Surg. 1995;24(6):433–439. doi:10.1016/S0901-5027(05)80262-5

Patil S, Maheshwari S, Sinha N, Parveen S. Comparative efficacy of intralesional corticosteroid, hyaluronidase, and their combination in treatment of oral submucous fibrosis. J Oral Biol Craniofac Res. 2015;5(1):11-15. doi:10.1016/j.jobcr.2014.11.003

More CB, Rao NR, More SV, Bhavsar K. Effectiveness of Aloe vera and antioxidant in the treatment of oral submucous fibrosis: a comparative clinical study. J Clin Diagn Res. 2012;6(10):1668-1673.

Gupta DS, Jain A, Agrawal R. Comparative efficacy of hydrocortisone with and without hyaluronidase in patients with oral submucous fibrosis. Contemp Clin Dent. 2015;6(3):345-351. doi:10.4103/0976-237X.161899

Ariyawardana A, Athukorala AD, Arulanandam A. Effect of betamethasone injections on oral submucous fibrosis: a clinical and histopathologic study. J Oral Pathol Med. 2005;34(4):200-204. doi:10.1111/j.1600-0714.2004.00312.x