Application of injection Kenacort, intradermal route in oral submucous fibrosis
Keywords:Pre-malignant conditions, Oral submucous fibrosis, Lycopene, Kenacort, Hyaluronidase
Background: Oral submucous fibrosis is a potentially pre-malignant disease, that results in progressive juxta-epithelial fibrosis of oral soft tissues, resulting in increased loss of tissue mobility, marked rigidity and inability to open the mouth. Actual treatment includes iron, multi vitamins, lycopene, pentoxifyline, steroid injections and human placental extracts. Currently available treatment with intradermal injection of Kenacort with hyaluronidase is effective to some extent.
Methods: This study was conducted at Basaveshwara Medical College and Hospital, Research Centre, Chitradurga, Karnataka, in the Otorhinolaryngology Department from February 2019 to August 2019 for 6 months duration. A total of 40 patients were included in this study. Mouth opening was recorded from baseline to 6 weeks. Cases were followed up for 6 months thereafter. Patients with positive history of chewing of betel-nuts, pan, gutkha and age from 18-50 years males and females were included in this study. Patients undergoing any surgery, allergic conditions, age more than 50 years were excluded. Mouth opening was assessed by objective type and subjective type.
Results: There was significant increase in mouth opening in patients after administration of intra-dermal Kenacort injection and oral lycopene. The results were statistically significant and patients responded better and p value <0.001.
Conclusions: Management of moderate oral submucous fibrosis should include counselling of patients along with oral lycopene with intradermal injection of Kenacort with hyaluronidase, is highly efficacious and cost- effective in improving the mouth opening and reducing other symptoms in patients with OSMF, whereas advanced stages should be treated surgically.
Akbar M. Oral submucous fibrosis – a clinical study. J Indian Dent Acad. 1976;48:365-73.
Chole RH, Gondivkar SM, Gadbail AR, Balsaraf S, Chaudhary S, Dhore SV, et al. Review of drug treatment for oral submucous fibrosis. Oral Oncol. 2012;48:393–8.
Kumar A, Begawadi A, Keluskar V, Singh M. Efficacy of lycopene in the management of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:207-13.
Singh M, Krishanappa R, Bagewadi A, Keluskar V. Efficacy of oral lycopene in the treatment of oral leukoplakia. Oral Oncol. 2004;40:591-6.
Chandra GDS, Rameshwar DS, Iqbal A. Treatment modalities in Oral submucous fibrosis:how they stand today? Study of 600 cases. Indian J Oral Maxillofacial Surg. 1992;7:43-7.
Ranganathan K, Devi Mu, Joshua E, Kirankumar K, Saraswathi TR. Oral submucous fibrosis:a case-control study in Chennai, South India. J Oral Pathol Med. 2004;33(5):274-7.
Selvam NP, Dayanand AA. Lycopene in the management of oral submucous fibrosis:a comparative study in Chennai. Innovare Acad Sci. 2013.
Maher R, Lee AJ, Warnakulasuriya KA, Lewis JA, Johnson NW. Role of areca nut in the causation of oral submucous fibrosis: a case-control study in Pakistan. J Oral Pathol Med. 1994;23(2):65-9.
Heber D, Lu Q-Y. Overview of mechanisms of action of lycopene. Exp Biol Med. 2002;227:920-3.
Palozza P, Parrone N, Catalano A, Simone R. Tomato lycopene and inflammatory cascade: basic interactions and clinical implications. Curr Med Chem. 2010;17(23):2547-63.
Kakar PK, Puri RK, Venkatachalam VP. Oral submucous fibrosis treatment with hyalase. J Laryngol Otol. 1985;99:57-9.
Borle RM, Nimonkar PV, Rajan R. Extendednasolabial flaps in the management of oral submucous fibrosis, Br J Oraland Maxillofacial Surg. 2009;47(5):382-5.
Naphade MV, Naphade UM. Major immunoglobulin status and lactate-dehydrogenaseis ozymeprofileinoralpre-malignancy and malignancy. Dental Dialogue Official J IDA, MSB. 2011;37:16–20.
Tilakaratne WM, Ekanayaka RP, Herath M, Jayasinghe RD, Sitheeque M, Amarasinghe H. Intralesional corticosteroids as a treatment for restricted mouth opening in oral submucous fibrosis Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122:224-31.
Singh M, Niranjan HS, Mehrotra R, Sharma D, 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.
Ariyawardana A, Nawagamuwa T, Ranasinghe A.J, Sitheeque M, Vithanaarachchi N. Conservative management of oral submucous fibrosis. Asian J Oral Maxillofac Surg. 2005;17(1):26-30.
Krishnan AR, Jayakrishnan. Oral submucous fibrosis: A progressive debilitating oral web disease. Global J Med Res: J Dent Otolaryngol. 2014;14(6):1-5.
Goswami R, Gangwani A, Bhatnagar S, Singh D. Comparative study of Oral Nutritional Supplements vs Intralesional Triamcinolone and Hyaluronidase in Oral Submucous Fibrosis. Int J Med Res Rev. 2014;2(2):114-8.
Chatterji P, Mehrotra R. Oral Submucous Fibrosis:A Study of Patient Profile. Int J Sci Stud. 2014;2(8):139-43.
Ghom AG, Gupta M, Deoghare A, Diwan R, Khandelwal A, Gandhi A. Comparison between Efficacy of Hydrocortisone / Hyaluronidase and Triamcinolone / Hyaluronidase in Combination with Lycopene / Pentoxifylline / Placebo Oral Supplementation in Treatment of Trismus in OSMF Patients. Chhattisgarh J Health Sci. 2013;1(1):8-11.