Oral submucous fibrosis

Oral submucous fibrosis (OSF) is a chronic, complex, premalignant condition of the oral cavity and the oropharynx, characterized by juxta-epithelial inflammatory reaction and progressive fibrosis of the submucosal tissues. It results in marked rigidity and an eventual inability to open the mouth. The condition is linked to oral cancers and is associated predominantly with the chewing of areca nut.

Etiology

The etiology of OSF is multifactorial. The main causative factor is the chewing of areca nut, a habit common in the Indian subcontinent and Southeast Asia. Other factors include nutritional deficiencies, immunologic processes, and genetic predisposition.

Pathogenesis

The pathogenesis of OSF is a complex process of changes in the oral mucosa. The chewing of areca nut causes a higher release of fibrogenic cytokines from the oral mucosa. This leads to increased collagen deposition and decreased collagen degradation, resulting in fibrosis.

Clinical features

OSF presents with recurrent ulceration, pain in the oral cavity, burning sensation, and difficulty in eating and opening the mouth. In advanced stages, there may be difficulty in speech, hearing, and swallowing.

Diagnosis

Diagnosis of OSF is based on clinical examination, history taking, and biopsy. The histopathological examination shows epithelial atrophy, chronic inflammation, and fibrosis.

Treatment

Treatment of OSF includes cessation of areca nut chewing, pharmacotherapy, physiotherapy, and surgical intervention. However, the prognosis is poor due to the high risk of malignant transformation.

See also

• Oral cancer
• Areca nut
• Oral pathology

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