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 94
- Downloads 0
COMPARATIVE EVALUATION OF 2% LIGNOCAINE AND 4% ARTICAINE IN INTRAORAL INFILTRATIVE ANAESTHESIA
BACKGROUND Though lignocaine stands as a time-tested local anaesthetic, articaine is becoming increasingly popular in recent times. METHODS This is a prospective double blinded study between 2% lignocaine and 4% articain...
A COMPARATIVE STUDY OF AGE BETWEEN RADIOLOGICAL EXAMINATION OF ELBOW JOINT AND BIRTH CERTIFICATES IN MALES
INTRODUCTION Assessment of age by radiological examination of ossification centers of bones is useful to solve several medicolegal and civil cases. Radiological examination plays a crucial role in sensitive cases where d...
A CLINICOPATHOLOGICAL STUDY OF CUTANEOUS SMALL VESSEL VASCULITIS IN A TERTIARY CARE CENTRE FROM NORTH KERALA
BACKGROUND Cutaneous small vessel vasculitis is a condition with various aetiologies, morphological patterns of presentation and histopathologic types. It can be primary or secondary. Cutaneous lesions being a pointer to...
MYELOPATHY OR ATYPICAL PRESENTATION OF GBS
PRESENTATION OF CASE A 53-year-old male presented to the Emergency Department of ESI Hospital complaining of recent onset tingling and numbness in both of his legs about, which he described as feeling sleepy. The symptom...
DIAGNOSIS OF MDR TUBERCULOSIS AT A TERTIARY CARE CENTRE WITH CBNAAT TECHNOLOGY- A TWO YEAR STUDY
BACKGROUND Tuberculosis is a chronic multi system granulomatous disease with a predilection for the respiratory system. Traditional diagnostic protocols include history, chest x-ray and sputum collection and staining for...