Oral Submucous Fibrosis and Hearing Impairment: An Overlooked Clinical Association- A short Review

Abstract Oral submucous fibrosis (OSMF) is a persistent, advancing, premalignant disorder marked by juxta-epithelial inflammation and fibrosis of the oral and oropharyngeal mucosa, primarily associated with areca nut chewing. Fibrosis often spreads to the soft palate and the paratubal muscles (tensor veli palatini and levator veli palatini), which makes the Eustachian tube not work right (ETD). This makes it harder for the Eustachian tube to stay open and for air to flow through the middle ear. This leads to negative middle ear pressure, serous otitis media, tympanic membrane retraction, and mostly conductive hearing loss (mild to moderate). There is a strong link between the severity of OSMF (clinical and histopathological grades) and hearing loss. Patients reported problems ranging from 27.69% to 76.7%, with a higher rate in later stages. Abnormal tympanometric results (like Type B/C curves) also suggest middle ear dysfunction. Early intervention, such as stopping bad habits, treating OSMF, and managing hearing loss, can often fix or lessen the hearing loss. However, advanced irreversible fibrosis may cause permanent hearing loss. Patients with OSMF should get care from a team of doctors and have regular ENT and audiological screenings. Key words: Oral submucous fibrosis, OSMF, Eustachian tube dysfunction, ETD, Conductive hearing loss, Hearing impairment, Middle ear function, Tympanometry, Audiometry, Areca nut.