We evaluated the use of extended nasolabial flaps and coronoidectomy in the management of 47 randomly selected patients with histologically confirmed oral submucous fibrosis. They all had interincisal opening of less than 25 mm and were treated by bilateral release of fibrous bands, coronoidectomy or coronoidotomy, and extended grafting with a nasolabial flap. All patients had postoperative physiotherapy, and were followed up for 2 years. Their interincisal opening improved significantly from a mean of 14 mm (range 3-23) to a mean of 41 mm (range 23-55). The procedure was effective in the management of patients with oral submucous fibrosis, the main disadvantage being the extraoral scars.