Oral Submucous Fibrosis and Elongated Styloid Process - Do they have an Alarming Inter-Connection?

Abstract

Oral Submucous Fibrosis is a premalignant condition affecting a considerable population around the world. The surge in the use of arecanut and tobacco products has led to monumental rise in young patients complaining of trismus and inability to eat. Although, the condition can be effectively managed through surgery followed by physiotherapy, its incessant subclinical progression often restores the intraoral fibrosis once physiotherapy is discontinued, most commonly due to pain. In this respect, it was intriguing to notice many such patients eliciting an elongated styloid process which may be consequent to activation of Transforming Growth Factor-beta due to chronic trauma or inflammation. This growth factor is also involved in marked deposition of collagen forming intraoral fibrous bands. Hence, if a definite association can be delineated between the two conditions, through radiographic examination on an orthopantomogram, clinicians can be alerted to diagnose an elongated styloid process whenever a case of oral submucous fibrosis presents in the clinical practice. This simple yet significant protocol shall eliminate a prominent cause of pain during mouth opening exercises thus making the chances of treatment failure negligible.

Elongated Styloid Process Evaluation Using Panoramic Radiography in Patients With Oral Submucous Fibrosis: A Retrospective Study

“…There are reports that the styloid process can vary in length from 15.2 mm to 47.7 mm. Numerous researchers have noted that the styloid process often measures 20 to 30 mm in length, with 31 mm and above considered elongated [ 18 ]. Congenital extension of the styloid process, calcification of the stylohyoid ligament, and the development of osseous tissue at the ligament's insert are all possible explanations for the styloid process's elongation; however, the exact origin remains a mystery [ 19 ].…”