Background: (OSMF) is a chronic, progressive disorder of the oral mucosa, characterized by fibrosis of the submucosal tissues, leading to restricted mouth opening, pain, and difficulty in oral functions. The condition is considered a precancerous lesion with a significant risk of malignant transformation, particularly in regions with high betel nut chewing prevalence. Despite its high prevalence, the management of OSMF remains challenging, with limited success from conservative therapies. Aim: This study aimed to evaluate the efficacy of intralesional dexamethasone combined with hyaluronidase in the management of OSMF, by assessing improvements in mouth opening, tissue flexibility, lesion appearance, and patient-reported symptoms. Methods: A total of 75 participants diagnosed at the ENT Department of Lord Buddha Koshi Medical College & Hospital mild to moderate OSMF were enrolled in this prospective interventional study. Participants received intralesional injections of dexamethasone (1 mg/ml) combined with hyaluronidase (150 IU/ml) at baseline, with follow-up assessments at 1, 3, and 6 months. Clinical assessments, including mouth opening measurement, lesion appearance, tissue flexibility, and symptom scores (pain and discomfort), were recorded at each visit. Statistical analysis was performed using SPSS version 23.0, with paired t-tests to compare pre- and post-treatment data. Results: Significant improvements were observed in mouth opening, lesion appearance, and tissue flexibility. The mean mouth opening increased from 22.4 mm at baseline to 37.2 mm at 6 months (p < 0.05). Lesion appearance scores decreased from 3.4 to 1.2, while tissue flexibility scores improved from 2.9 to 4.6 (both p < 0.05). Symptom scores for pain and discomfort significantly decreased from a mean of 6.8 at baseline to 2.0 at 6 months (p < 0.05). Histopathological evaluations on a subset of participants showed 85% reduction in fibrosis. Conclusion: Intralesional dexamethasone combined with hyaluronidase proved to be an effective treatment for OSMF, resulting in significant clinical improvements in mouth opening, lesion severity, tissue flexibility, and symptom relief. The treatment was well tolerated with minimal adverse effects, and no serious complications were reported. Recommendations: Further studies with larger sample sizes and longer follow-up periods are recommended to confirm the long-term efficacy and safety of this treatment approach. Additionally, exploring the combination therapy with other modalities may enhance the therapeutic outcomes for OSMF.

Background: (OSMF) is a chronic, progressive disorder of the oral mucosa, characterized by fibrosis of the submucosal tissues, leading to restricted mouth opening, pain, and difficulty in oral functions. The condition is considered a precancerous lesion with a significant risk of malignant transformation, particularly in regions with high betel nut chewing prevalence. Despite its high prevalence, the management of OSMF remains challenging, with limited success from conservative therapies. Aim: This study aimed to evaluate the efficacy of intralesional dexamethasone combined with hyaluronidase in the management of OSMF, by assessing improvements in mouth opening, tissue flexibility, lesion appearance, and patient-reported symptoms. Methods: A total of 75 participants diagnosed at the ENT Department of Lord Buddha Koshi Medical College & Hospital mild to moderate OSMF were enrolled in this prospective interventional study. Participants received intralesional injections of dexamethasone (1 mg/ml) combined with hyaluronidase (150 IU/ml) at baseline, with follow-up assessments at 1, 3, and 6 months. Clinical assessments, including mouth opening measurement, lesion appearance, tissue flexibility, and symptom scores (pain and discomfort), were recorded at each visit. Statistical analysis was performed using SPSS version 23.0, with paired t-tests to compare pre- and post-treatment data. Results: Significant improvements were observed in mouth opening, lesion appearance, and tissue flexibility. The mean mouth opening increased from 22.4 mm at baseline to 37.2 mm at 6 months (p < 0.05). Lesion appearance scores decreased from 3.4 to 1.2, while tissue flexibility scores improved from 2.9 to 4.6 (both p < 0.05). Symptom scores for pain and discomfort significantly decreased from a mean of 6.8 at baseline to 2.0 at 6 months (p < 0.05). Histopathological evaluations on a subset of participants showed 85% reduction in fibrosis. Conclusion: Intralesional dexamethasone combined with hyaluronidase proved to be an effective treatment for OSMF, resulting in significant clinical improvements in mouth opening, lesion severity, tissue flexibility, and symptom relief. The treatment was well tolerated with minimal adverse effects, and no serious complications were reported. Recommendations: Further studies with larger sample sizes and longer follow-up periods are recommended to confirm the long-term efficacy and safety of this treatment approach. Additionally, exploring the combination therapy with other modalities may enhance the therapeutic outcomes for OSMF.