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Introduction
Oral submucous fibrosis (OSMF) is a chronic disabling disease associated with habitual betel quid chewers. In India, 2.5 million people are suffering from OSMF characterized by limitation of oral opening resulting in difficulty in chewing. The pathological changes are irreversible. Physiotherapy is offering third dimension to the management apart from medication and surgery. Therapeutic ultrasound help makes fibrous tissue more pliable and gradual stretching of oral tissues helping to improve trismus.
Methodology
Hospital based Research questions. i) Does therapeutic ultrasound with mouth opening exercises improve the MMO (maximum mouth opening) in patients of OSMF as palliative measure? ii) Does therapeutic ultra sound helps in reducing oral Sensitivity to spicy food as measured onVAS? Study design: Hospital based, before & after effect evaluation case series Case selection: Patients with M.M.D. < 35mm & localized or generalized O.S.M.F. diagnosed by senior ENT Surgeons patient who received other local modalities like Intralesional injection was excluded. Study factors: Ultra sound therapy and Jaw opening exercise. Out come factors: 1. Measurement of M.M.O. before & one week after treatment. 2. Measurement of symptoms of burning in mouth using VAS.
Results
Total 30 patients were enrolled in the study. The mean age of patients was 33.56 years with range of 18- 55years and 4:1 male: female ratio. Trismus was main presenting symptom in all 30 patients and 86.66% has burning in mouth Pan masala & tobacco were the main risk factors seen 63.33 % & 46.66% patients. The mean M.M.O. before treatment was 24.06mm, which improved to 27.8mm(P=0.001) after treatment. The mean post therapy V.A.S.score for burning sensation in mouth came down from 6 to 3.33 (P=0.01)
Conclusion
Ultrasound therapy followed by jaw opening exercises can be an alternate mode of treatment for palliation in OSMF to improve trismus the main morbidity
