Reconstruction of the Acquired Facial Deformity due to Cancrum Oris Sequelae

괴저성 구내염 후유증에 의한 후천성 안면 변형의 재건

  • Moon, Jae Won (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Lee, Seung Chan (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Cheon, Ji Seon (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Yang, Jeong Yeol (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University)
  • 문재원 (조선대학교 의과대학 성형외과학교실) ;
  • 이승찬 (조선대학교 의과대학 성형외과학교실) ;
  • 천지선 (조선대학교 의과대학 성형외과학교실) ;
  • 양정열 (조선대학교 의과대학 성형외과학교실)
  • Received : 2006.03.21
  • Published : 2006.05.10

Abstract

Acquired facial deformities following cancrum oris sequelae manifested variably according to the nature of tissue necrosis. In cases that tissue loss extends over a wide area of the face, or the tissue nature is different due to congenital facial cleft, it is difficult to reconstruct with a single operation. As cancrum oris has virtually disappeared from our country, clinical report of reconstruction is also rare. We report 5 cases of facial deformities following cancrum oris sequelae. Since 1988, five adult patients(4 female and 1 male) were treated by authors. These patients, with an age ranged from 47 to 58 years, all suffered from acquired facial cleft such as facial mutilation, asymmetry. The stages of operation were from 1 to maximum of 5 operations. All surgeries achieved satisfactory results after a long-term follow-up. But one surgery in the case of palatal mucosal flap for the coverage of reconstructed maxilla alveolar bone resulted tissue sloughness, followed by osteomyelitis. Those were debrided and discarded. In conclusion, all sites of deformities were positioned around one of the oral commissures. In their past medical history, they have been suffering from measles, typhoid fever and unknown febrile illness. We diagnosed the acquired facial deformity following cancrum oris sequelae. The reconstruction of acquired facial deformity following cancrum oris sequelae were difficult due to extensive multiple tissue defects. Therefore multiple staged operations were inevitable. The authors reconstructed 5 cases of simple and complex form of facial deformity with minimum staged operations. All patients were satisfied functionally and cosmetically.

Keywords

Acknowledgement

Supported by : 조선대학교병원

References

  1. Stassen LFA, Batcheolar AGG, Rennie JS, Moos KF: Cancrum oris in an adult Caucasian female. Br J Oral Maxillofac Surg 27: 417, 1989 https://doi.org/10.1016/0266-4356(89)90083-1
  2. Sawyer DR, Nwoku AL: Cancrum oris(noma): Past and present. ASDC J Dent Child 48: 138, 1981
  3. Shin YJ, Yoon KC: Clinical experience of reconstructing acquired facial cleft deformity. J Korean Soc Plast Reconstr Surg 16: 833, 1989
  4. Seol JY, Yang JY: Clinical experience of reconstructing facial deformity due to acute febrile disease. J Korean Soc Plast Reconstr Surg 19: 808, 1992
  5. McCarthy JG, Grayson BH, Coccaro PJ, Wood-Smith D: Craniofacial microsomia. In McCarthy JG(ed): Plastic Surgery. Philadelphia, Saunders, 1990, p 3085
  6. Montandon D, Lehman C, Chami N: The surgical treatment of noma. Plast Reconstr Surg 87: 76, 1991 https://doi.org/10.1097/00006534-199101000-00013
  7. Tempest MN: Cancrum oris. Br J Surg 53: 949, 1966 https://doi.org/10.1002/bjs.1800531109
  8. Osler SW: Principles and practice of medicine. New York, Applerfon-century-crofts, 1938, p 563
  9. Caddell JL: Magnesium in the therapy of orofacial lesions of severe protein-calorie malnutrition. Br J Surg 56: 826, 1969 https://doi.org/10.1002/bjs.1800561107
  10. Heitland AS, Pallua N: The single and double-folded supraclavicular island flap as a new therapy option in the treatment of large facial defects in noma patients. Plast Reconstr Surg 115: 1591, 2005 https://doi.org/10.1097/01.PRS.0000160694.20881.F4
  11. Barthelemy I, Martin D, Sannajust JP, Marck K, Pistre V, Mandie JM: Prefabricated superficial temporal fascia flap combined with a submental flap in noma surgery. Plast Reconstr Surg 109: 936, 2002 https://doi.org/10.1097/00006534-200203000-00019
  12. Giessler GA, Fieger A, Cornelius CP, Schmidt AB: Microsurgical reconstruction of Noma-related facial defects with folded free flaps: an overview of 31 cases. Ann Plast Surg 55: 132, 2005 https://doi.org/10.1097/01.sap.0000165688.50780.e9