Microstomia Release in Post-burn Contractures: A Case Report

Microstomia following orofacial and neck burns with subsequent contractures poses a significant challenge to the anesthesiologist as well as the plastic surgeon. Fibrosed external nares, microstomia, and contracture bands make a difficult airway. Deformed facial structure and raw area of burns make ventilation difficult. One of the significant causes of morbidity and mortality under anesthesia is the "cannot intubate, cannot ventilate" scenario. Further reconstruction of oral commissures in such cases is always challenging because it provides good functional and acceptable aesthetic results. Here, we present a case of microstomia having limited mouth opening in which fiberoptic nasal intubation and bilateral oral commissuroplasty were performed for microstomia release. In our case, we achieved mouth opening, which was preoperatively 15 mm to 55 mm postoperatively using Dieffenbach commissuroplasty.