2089208 Ultrasound Evaluation And Grading Of Oral Submucous Fibrosis

Oral submucous fibrosis(OSMF) is a potentialy dangerous pre- malignant lesion of the oral cavity.Oral cancer is highly prevalent in many parts of Asia.One of the most important factor for poor prognosis of oral cancer is late presentation.Evaluation at early stage is a crucial step in better prognosis.OSMF is a very important pre malignant lesion,clinical evaluation and biopsy are the mainstay in diagnosis.In cases of severe restriction of mouth opening biopsy cannot be taken ,further biopsy cannot be repeated to monitor disease progression or respose to treatment.Biopsy is a surgical procedure with less patient compliance and a biopsy taken from one site does not represent the general disease severity as involvement of fibrosis varies at different parts of submucosa in some cases.A systematic review by the Cochrane database suggests that extraoral imaging would serve to be a better imaging tool to evaluate disease load.Our aim was to evaluate the entire submucosa and depict the changes on ultrsound and predict the severity of disease. Patients were referred from oral surgery department with provisional diagnosis of oral submucous fibrosis, in advanced cases there was no clinical findings or diagnosis. Patients were scanned in axial and coronal planes at specific areas using puff cheek and fruit jelly technique, scan was performed using 12mhz linear transducer in panoramic mode.Findings were compared with histopathological exam.Study period - two years. Entire extent of submucosa was visualized using the extraoral panoramic imaging technique.Normal submucosa was separately seen from mucosa and buccinator.There was change in the echogenecity of the submucosa with progression of the disease.Focal areas of involvement were depicted with focal alteration of echotexture in early cases.In cases of varied involvement of fibrosis ultrasound was helpfull to guide the biopsy to a specific site. Ultrasonography is a reliable cost effective imaging tool to evaluate and grade oral submucous fibrosis.Ultrasound being a non ionic source has better patient compliance with less cost and allows real time imaging serves as the ideal modality of choice in these circumstances.