Distribution of Oral Submucous Fibrosis Cases and Malignant Transformation Rate among Bhutanese Patients Treated at Jigme Dorji Wangchuck National Referral Hospital, Bhutan

Abstract

BACKGROUND: Oral Submucous Fibrosis (OSMF) is a chronic, insidious, scarring disease of the mouth often involving the palate, oro-pharynx, pharynx, esophagus, tongue and the buccal mucosa which leads to ulceration, blanching and ultimately limited mouth opening. The aim of the study is to describe the age, gender and district-wise distribution of oral submucous fibrosis cases and to assess the malignant transformation rate among the patients with oral submucous fibrosis who were treated at Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.MATERIALS AND METHOD: This is a descriptive retrospective study. The patients were clinically diagnosed by examining their mouth and by measuring their mouth opening (Inter-incisal height). Patients who had less than 3 fingers mouth opening and diagnosed as Oral submucous fibrosis (OSMF) during these three-year period from 2018 to 2020 were considered for the study.RESULTS: There were 278 cases in total. Thimphu district had the maximum number of cases followed by Wangduephodrang and Samtse. Gasa and Haa districts had the minimum cases. More males were affected than females. The malignant transformation rate among these patients was 4.3%.CONCLUSION: Thimphu district had the highest proportion of OSMF cases and was almost equally distributed among genders. Over 90% of the patients reported improvement without surgery while the malignancy transformation rate was 4.3%. The study recommends conducting screening in districts with high burden of OSMF cases for early diagnosis and treatment.