Zusammenfassung
Hintergrund
Die orale submuköse Fibrose (OSF) ist ein chronisches Krankheitsbild mit Fibrosierung des subepithelialen Bindegewebes der Mundhöhle und angrenzender Strukturen. Die OSF wird den oralen Präkanzerosen zugeordnet. Die Ursache ist das Kauen von Betel (Areca catechu L., Piper betle, Kalziumhydroxid, Tabak), vor allem aber von industriell hergestellten Produkten wie Pan Masala und Gutka, die in Südasien verbreitet sind. Das Leitsymptom der OSF ist die zum Teil extreme Einschränkung der Mundöffnung.
Fallbericht
Eine seit 1997 in Deutschland lebende 31-jährige Inderin stellte sich wegen zunehmender Mundöffnungseinschränkung vor. Sie gab an, seit dem 17. Lebensjahr Pan Masala und Gutka zu kauen. Die Anamnese, der klinische und histologische Befund ermöglichten die eindeutige Diagnose einer OSF.
Diskussion
Therapeutische Maßnahmen, sowohl konservativer als auch chirurgischer Art, führen bis heute zu keinen zufrieden stellenden Langzeitergebnissen. Da die OSF bereits bei Kindern und Jugendlichen auftreten kann, sollte das primäre Ziel sein, die Mundöffnungseinschränkung aufzuhalten oder zu verbessern. Chirurgische Maßnahmen sollten nicht zu früh erfolgen, da häufig Mehrfacheingriffe notwendig werden. Aufgrund einer zunehmenden Zahl von Migranten aus Südasien ist in Zukunft auch mit einer zunehmenden Zahl von Patienten mit OSF zu rechnen, da die arecanusshaltigen Produkte auch in Deutschland erhältlich sind.
Abstract
Background
Oral submucous fibrosis (OSF) is a chronic disease characterized by subepithelial collagen deposition with formation of bands involving the oral cavity and adjacent structures. Oral submucous fibrosis is a precancerous condition. It is caused by chewing of betel quid (Areca catechu L., Piper betle, lime and tobacco) and ready-made products like pan masala and gutka which also contain areca nut. These products are available all over South Asia. The hallmark of OSF is extremely restricted mouth opening.
Case report
A 31-year-old Indian woman who has lived in Germany since 1997 presented herself because of limitation of mouth opening. She reported that she has chewed pan masala and gutka since she was 17 years of age. History, clinical and histological findings clearly pointed to the diagnosis of OSF.
Discussion
Conservative as well as surgical interventions for OSF have not resulted in adequate long-term results. Since OSF may occur in children and young adults, the primary aim should be to avoid progression of the disease, initially by physiotherapy. Surgical interventions should not be applied at an early stage of the disease because recurrences and further surgical interventions are often necessary. Due to the increasing numbers of migrants from South Asia more cases of OSF will probably also be observed in Germany, where areca nut-containing products are also available.
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Reichart, P.A., Philipsen, H.P. Orale submuköse Fibrose bei einer 31-jährigen Inderin. Mund Kiefer GesichtsChir 10, 192–196 (2006). https://doi.org/10.1007/s10006-006-0671-7
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DOI: https://doi.org/10.1007/s10006-006-0671-7