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Extreme microstomia in an 8-month-old infant: bilateral commissuroplasty using rhomboid buccal mucosa flaps
Patrick Jaminet1, Frank Werdin, Armin Kraus
1Department of Plastic, Hand and Reconstructive Surgery, Burn Center, BG-Trauma Center, Eberhard-Karl University of Tübingen, Schnarrenbergstr. 95, 72076 Tübingen, Germany. patrickjaminet@googlemail.com
Insights
A life-threatening case of extreme microstomia in an infant, caused by acid ingestion, was successfully treated with surgical reconstruction. The infant regained normal feeding and oral functions, demonstrating a positive outcome.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Plastic and Reconstructive Surgery
Background:
- Extreme microstomia can result from caustic acid ingestion in infants, leading to severe feeding difficulties.
- Progressive stricture of the perioral region significantly impairs normal oral intake and function.
Purpose of the Study:
- To present a surgical technique for correcting extreme microstomia in an infant.
- To evaluate the functional and esthetic outcomes of the surgical intervention.
- To review the limited literature on managing such severe cases.
Main Methods:
- Bilateral commissurotomies were performed.
- Four rhomboid flaps based in the buccal mucosa were utilized for reconstruction.
Main Results:
- Successful enlargement of the mouth aperture was achieved.
- Soft tissue defects were effectively covered with good esthetic results.
- The infant regained the ability to use a feeding bottle and demonstrated improved oral dynamics, including laughing and crying.
Conclusions:
- The described surgical technique offers a viable solution for life-threatening microstomia in infants.
- The procedure yielded favorable functional and esthetic outcomes.
- This case highlights the severity and rarity of microstomia following childhood acid ingestion.
Objective:
A case of extreme microstomia in an 8-month-old infant is presented. As a result of caustic acid ingestion at the age of a few weeks, the male infant developed progressive stricture of the perioral region preventing him from normal food intake.
Methods:
The patient was treated by bilateral commissurotomies and a total of 4 rhomboid flaps based in the buccal mucosa.
Results:
We were able to enlarge the mouth aperture and subsequently cover the created soft tissue defects, with good esthetic result. The patient learned to suck the feeding bottle and was able to demonstrate oral dynamics, including laughing and crying.
Conclusion:
We present our surgical technique, the postoperative functional and esthetic outcome, and a brief literature review. Only few publications deal with the same matter and none with a similar life-threatening case.