A CORRELATIVE STUDY OF HISTOLOGICAL STAGING AND CLINICAL SEVERITY OF TRISMUS IN PATIENTS WITH ORAL SUBMUCOUS FIBROSIS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 25
Abstract
BACKGROUND Oral submucous fibrosis (OSF) is a potentially malignant disease that primarily affects any part of the oral cavity and sometimes the pharynx. The disease is chronic, insidious and progressive in nature. It causes mucosal rigidity resulting in discomfort, burning and limitation of opening of the mouth. Blanching of the oral mucosa is an important clinical feature seen in the early stage of OSF. The present study had been undertaken to correlate the clinical staging of mouth opening with histopathological grading in OSMF patients. We wanted to morphometrically quantify the histopathological changes in oral submucous fibrosis and to correlate them with grading and clinical severity of trismus. METHODS 78 patients diagnosed clinically were subjected to biopsy of the lesions from their periphery and compared with the normal areas. The criteria proposed by Pindborg and Sirsat (1966), who described four consecutive stages based upon sections stained with haematoxylin and eosin were used. The stages were classified as: 1) Very early stage: Characterized by fine collagen dispersed with marked oedema, prominent fibroelastic response dilated and congested blood vessels and inflammatory cells (mainly polymorphs and eosinophils). 2) Early stage: Early hyalinization in juxta epithelial area with thickened separate bundles of collagen and clumps of young fibroblasts in moderate number. 3) Moderately advanced stage: Moderately hyalinized collagen, the amorphous change starting from the juxta-epithelial basement membrane. RESULTS Among 78 patients with OSF, 57 were males (73.07%) and 21 were females (26.92%). Among them, histologically 19 (24.35%) were of very early stage, 27 (34.61%) of early stage and 22 (28.20%) of moderately advanced stage and 10 (12.82%) patients were in advanced stage. Collagenization was observed in 17/22 of moderately severe OSF and 10/10 of severely affected OSF. The thickness of the epithelium and subepithelial collagen showed no statistically significant differences between the different stages. However, blood vessel density was indirectly proportional to the histological stages. Histological stages directly correlated the frequency of trismus, but the severity of trismus showed no relation to the epithelial thickness or collagenization. CONCLUSIONS The thickness of the epithelium and subepithelial collagen should not be included in the histological staging criteria of oral submucous fibrosis. Probably the degree of hyalinization of collagen fibres and involvement of muscle fibres are more important in causing trismus, rather than a simple increase in the subepithelial collagen thickness.
Authors and Affiliations
Satyanarayana Sharma V. , Vamsi Krishna M. , Subba Rao M. V. , Pravin Tez S, Vandana Telangana
Keywords
Related Articles
- EP ID EP668378
- DOI 10.18410/jebmh/2019/350
- Views 88
- Downloads 0
SIGNIFICANCE OF LACTATE DEHYDROGENASE AND ASPARTATE TRANSAMINASE AS BIOCHEMICAL MARKERS AND AS PREDICTORS OF SEVERITY OF PREGNANCY-INDUCED HYPERTENSION AND ITS COMPLICATIONS
BACKGROUND To compare serum Lactate Dehydrogenase (LDH) and serum Aspartate Transaminase (AST) of normotensive pregnant women with those of preeclamptic and eclamptic women. To determine the relationship of levels of ser...
A CLINICAL STUDY AND SURGICAL MANAGEMENT OF CARCINOMA OESOPHAGUS AT KIMS, HUBLI
BACKGROUND Carcinoma oesophagus is aggressive tumour with poor prognosis occurring in mid to late adulthood with most cases presenting in the late stages. Surgical therapy remains the main stay therapy. Survival rate var...
EVALUATION OF OUTCOME OF VARIOUS SURGICAL PROCEDURES FOR UPPER EYELID PTOSIS
INTRODUCTION: There are various procedures available for ptosis correction. Successful outcome not only depends on correct technique but also choosing appropriate procedure for each patient. Selection of procedure is bas...
CARCINOMA CERVIX IN PREGNANCY – A CASE REPORT
Carcinoma cervix is one of the most common malignancies in pregnancy with an estimated incidence of 0.8 to 1.5 cases per 10000 births. (1,2) 1-3% of women who are diagnosed to have cervical cancer are pregnant or in post...
SINGLE DOSE INTRAVENOUS CARBOXYMALTOSE VERSUS ORAL IRON THERAPY IN THE TREATMENT OF ANAEMIA IN POSTPARTUM PATIENTS IN A RURAL AREA
BACKGROUND To compare the efficacy and safety of oral and intravenous administration of iron supplement (single dose of ferric carboxymaltose) for treating postpartum anaemia. MATERIALS AND METHODS It is a longitudinal i...