Efficacy of local and systemic corticosteroid and hyaluronidase therapy in oral submucous fibrosis: a histopathological study
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20190781Keywords:
Oral submucous fibrosis, Corticosteroids, Hydrocortisone, HyaluronidaseAbstract
Background: As the etiopathogenesis of OSMF is not well established, a myriad of different medical and surgical modalities of treatment are reported however studies on histopatholgical changes after treatment are very sparse. There are reports on various regimens of steroids using different molecules, doses and routes of administration and their combination with other drugs. These were the driving factors to conduct this study. This histopathological study was conducted to know the efficacy of various forms of steroid therapy in various combinations.
Methods: This prospective randomized single blinded outcome based study was conducted in the department of Otorhinolaryngology (ENT) and Pathology in a tertiary care medical college hospital. The 150 clinically diagnosed patients were divided into 5 groups: A, B, C, D and E. Each group was treated differently with different modes of administration of steroids with and without combinations of other medicines. To study histopathological changes before and after treatment, biopsy was taken in 100 patients who gave their consent for the same.
Results: The various histopathological changes observed in the tissues taken after the treatment in 100 patients, were in terms of changes in the epithelium towards normalisation, decrease in fibrous tissue in the submucosa, decrease in the cellular infiltration, appearance of new capillaries, restoration of glandular activity and decrease in the fibrosis of muscles. The calculated Chi square value (p>0.05) was found less than table value.
Conclusions: Local and systemic corticosteroid and hyaluronidase therapy in patients with OSMF were found effective. However, histopathologically, it was not found statistically significant whether corticosteroids are given locally and/or systemic with or without injection hyaluronidase.
Metrics
References
Bansal M. Diseases of Ear, Nose and Throat with Head and Neck Surgery. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2018: 407-409.
Angadi PV, Rekha KP. Oral submucous fibrosis: a clinicopathologic review of 205 cases in Indians. Oral Maxillofac Surg. 2011;15(1):15-9.
Tilakaratne WC, Ekanayaka RP, Warnakulasuriya S, Oral submucous fibrosis: a historical perspective and a review on etiology and pathogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(2):178-91.
Joshi SG. Submucous fibrosis of palate and pillars. Ind J Otol. 1953;4:110.
Wahi PN, Kapur VL, Luthra UK, Srivastava MC. Submucous fibrosis of oral cavity: studies on epidemiology. Bull WHO. 1966;35:793.
Desa JV. Submucous fibrosis of palate and cheek. Annals of Otol. 1957;66:1143.
Sirsat SM, Khanolkar VR. “Histological, electron microscope and enzyme studies of submucous fibrosis of the palate. J Pathol Bacteriol. 1960;79:53-8.
Rao ABN. Idiopathic palatal fibrosis. Br J Surg. 1962;50:23.
Bansal M. Essentials of Ear, Nose and Throat. 1st ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd. 2016: 262-264
Pindborg JJ, Mehta PS, Daftary DK. Occurrence of epithelial atypia in 51 Indian villagers with oral submucous fibrosis. Br J Cancer. 1970;24:253.
Pindborg JJ. Oral submucous fibrosis: a review. Ann Acad Med Surg. 1989;18:603-7.
Singh M, Niranjan HS, Mehrotra R, Sharma D, and Gupta SC. Efficacy of hydrocortisone acetate/ hyaluronidase vs triamcinolone acetonide/ hyaluronidase in the treatment of oral submucous fibrosis. Indian J Med Res. 2010;131:665-9.
Kakar PK, Puri RK, Venkatachalam VP. Oral submucous fibrosis- treatment with hyalase. J Laryngol Otol. 1985;99:57-9.
Haque MF, Meghji S, Nazir R, Harris M. Interferon gamma (IFN -gamma) may reverse oral submucous fibrosis. J Oral Pathol Med. 2001;30:12-21.
Rajendran R, Rani V, Shaikh S. Pentoxifylline therapy: new adjunct in the treatment of oral submucous fibrosis. Indian J Dent Res. 2006;17:190-8.
Kerr AR. Efficacy of oral lycopene in the management of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:214-5.
Das DA, Balan A, Sreelatha KT. Comparative study of the efficacy of curcumin and turmeric oil as chemopreventive agents in oral submucous fibrosis: a clinical and histopathological valuation. J Indian Acad Oral Medi Radiol. 2010;22(2):88-92.
Kumar A. Sharma SC, Sharma P, Chandra OM, Singhal KC, Nagar A. Beneficial effect of oral zinc in the treatment of oral submucous fibrosis. Indian J Pharmac. 1991;23:236-41.
Su IP. Idiopathic scleroderma of the mouth. Arch Otol. 1954;59:330.
Paymaster JC. Cancer of buccal mucosa: clinical study of 650 cases in Indian patients. Cancer. 1956;9:431.
Pindborg JJ, Sirsat MS. Oral submucous fibrosis. Oral Surg. 1966;22:764.