Original ArticlesTotal Oral Reconstruction for Cancers Associated With Advanced Oral Submucous FibrosisCunha–Gomes, Dean MS, MCh*; Kavarana, Naozer M. MS*; Choudhari, Charudatta MS, DNB*; Rajendraprasad, J.S. MS, MCh†; Bhathena, Hoshi M. MS, MCh†; Desai, Praful B. MS, FRCS*; Vyas, Jeetendra J. MS, FRCS*; Gangwal, Sanjay MS*Author Information From the Departments of Plastic & Reconstructive Surgery and Oncosurgery, *Bombay Hospital Medical & Research Centre and †Tata Memorial Hospital, Mumbai, India. Received May 15, 2001, and in revised form Dec 23, 2002. Accepted for publication Dec 23, 2002. Address correspondence and reprint requests to Dr Cunha–Gomes, Bahrain Specialist Hospital, PO Box 10588, Kingdom of Bahrain. Cunha–Gomes D, Kavarana NM, Choudhari C, Rajendraprasad JS, Bhathena HM, Desai PB, Vyas JJ, Gangwal S. Total oral reconstruction for cancers associated with advanced oral submucous fibrosis. Annals of Plastic Surgery: September 2003 - Volume 51 - Issue 3 - p 283-289 doi: 10.1097/01.SAP.0000063753.91476.05 Buy Metrics AbstractIn Brief The progression of submucous fibrosis to oral cancer is well established. This condition in an advanced stage causes progressive trismus. Oral cancers associated with severe submucous fibrosis (interincisor distance [IID] ≤ 1.5 cm) require bilateral buccal mucosal reconstruction after tumor excision. After wide excision of the tumor, a regional flap is used to reconstruct the buccal mucosal loss on that side. The opposite buccal mucosa, afflicted by advanced submucous fibrosis, is released at the same time to open the mouth and is resurfaced by an ipsilateral, inferiorly based nasolabial flap. This helps to rehabilitate the oral cavity completely and to prevent the recurrence of trismus. In 18 months, 12 patients underwent total reconstruction of intraoral tumors associated with submucous fibrosis. The average preoperative IID was 0.875 cm. All patients had inferiorly based, two-stage nasolabial flaps for submucous fibrosis reconstruction. The average pain-free postoperative IID was 3.13 cm. Twelve patients underwent excision of severe buccal submucous fibrosis with reconstruction by inferiorly based nasolabial flaps to increase interincisal distance. Flap division and inset was performed 21 days later under local anesthesia with 100% flap survival. © 2003 Lippincott Williams & Wilkins, Inc.