Coronoidotomy, the Way Forward? Coronoidectomy vs Coronoidotomy in Oral Submucous Fibrosis

This case series report aims at assessment of coronoidotomy as compared to coronoidectomy in the treatment of oral submucous fibrosis (OSMF) cases. With the increasing incidence of OSMF, the aim of the study is to depict our experience with coronoidotomy and its efficiency.

This case series report looks to compare the efficacy of coronoidotomy with the more traditional approach of coronoidectomy.

A retrospective study of 40 Patients were divided into 2 groups of Coronoidotomy vs Coronoidectomy using buccal fat pad (BFP) for reconstruction carried out under local anesthesia (LA)/General anesthesia (GA) and Coronoidotomy vs Coronoidectomy using Nasolabial flap reconstruction carried out under GA.

A comparison of pain scale during physiotherapy using Visual analog scale VAS and Verbal response score VRS (along with ease of physiotherapy), duration required to attain adequate mouth opening,interincisal mouth opening and duration of the surgery was done. The secondary outcome variables includes division between nasolabial and buccal fat pad flaps.

Time since cessation of habit and the overall time period of the habit were recorded.

Statistical comparison of all values with a P value ≤ 0.05.

Among the 40 study participants, Patients undergoing Coronoidotomy tend to respond better with a statistically significant lower pain scale during physiotherapy and tend to have a shorter operating time with comparable interincisal results to coronoidectomy even on a 2 year follow-up, irrespective of the type of reconstruction.

Coronoidotomy have comparable end results to that of coronoidectomy with faster operating time and lesser pain during physiotherapy and thus is now becoming the treatment of choice in Grade III/IV cases of OSMF. It is also seen that similar results can be attained when the procedure is done using buccal fat pad and coronoidotomy under local anesthesia under certain circumstances.