Using pneumo-computerized tomography as a quantitative assessment of result in submucous fibrosis patients treated with surgical release and free flap reconstruction.
OBJECTIVE
This study investigates the efficacy of oral submucous fibrosis release and free flap reconstruction.


METHODS
Pneumo-computerized tomography (pneumo-CT) was used to evaluate postoperative changes in the buccal vestibular volume during maximum blowing.


METHODS
From March 2003 to November 2008, 9 patients underwent 18 microvascular flap reconstructions after oral submucous fibrosis release. The preoperative and postoperative buccal vestibular volumes were determined by capturing the air density in the selected region on CT images, which were composed of 0.75-mm-thick slices that were then summated using analysis software (Biomedical Imaging Resource; Mayo Foundation, Rochester, MN).


RESULTS
Postoperative results were measured for a mean follow-up period of 15 months (range, 6-36 mo). There was significant improvement in the interincisal distance from 12.44 (8.35) mm preoperatively to 32.56 (7.322) mm postoperatively (P = 0.000). There was an accompanying significant increase in the buccal vestibular volume from 5.66 (3.92) mL preoperatively to 9.38 (4.96) mL postoperatively on the right side (P = 0.032) and from 6.44 (4.20) mL preoperatively to 9.64 (4.65) mL postoperatively (P = 0.048) on the left side.


CONCLUSIONS
Adequate release of the mucosa and resurfacing with a free flap can increase the interincisal distance and improve the maximal buccal vestibular volume. Air-contrast pneumo-CT studies demonstrate an improvement in buccal mucosal elasticity.
From the Departments of *Plastic Surgery, Chang Gung Memorial Hospital; †Diagnostic Radiology, ‡Plastic Surgery, and §Oral-Maxillofacial Surgery, Chang Gung Memorial Hospital, Lin Kuo, and Chang Gung University Medical College, Taoyuan, Taiwan.
Chang-Cheng
CC
Chang
Shu-Hang
SH
Ng
Wee-Leon
WL
Lam
Chi-Ying
CY
Tsai
Yang-Ming
YM
Chang
Fu-Chan
FC
Wei
D000328:Adult; D004548:Elasticity; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000000981:diagnostic imaging / Q000601:surgery; D009914:Oral Submucous Fibrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011029:Pneumoradiography / Q000379:methods*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014313:Trismus / Q000000981:diagnostic imaging / Q000601:surgery