The prefabricated superficial temporal fascia flap in noma surgery

Marck, Klaas W.; Lei, Berend van der; Spijkervet, Fred K. L.; Adeniyi, Semiu Adetunji; Meixner, J.; Bruijn, Hans P. de

doi:10.1007/s002380050247

Cited by 13 publications

(6 citation statements)

References 14 publications

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“…Studies have highlighted the fact that the time between acute illness and surgical care can be decades [ 136 , 141 , 144 ]. The clinical manifestation of each noma case is unique, and as such, the surgical procedures used to treat each noma case differ [ 15 , 39 , 42 , 74 , 102 , 115 – 117 , 145 , 148 ]. Reported surgical techniques include pedicled supraclavicular flaps for the treatment of large unilateral facial defects [ 102 , 117 ]; myocutaneous submental artery flaps, bony and/or soft tissue trismus releases [ 109 ], forehead flaps [ 109 , 144 ] and lower lid ectropion release [ 109 ].…”

Section: Resultsmentioning

confidence: 99%

Noma (cancrum oris): A scoping literature review of a neglected disease (1843 to 2021)

Farley

Mehta

Srour³

et al. 2021

PLoS Negl Trop Dis

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Background Noma (cancrum oris) is an ancient but neglected and poorly understood preventable disease, afflicting the most disenfranchised populations in the world. It is a devastating and often fatal condition that requires urgent and intensive clinical and surgical care, often difficult to access as most cases of noma occur in resource-limited settings. We conducted a scoping review of the literature published on noma to understand the size and scope of available research on the disease and identify research gaps that need to be addressed to evolve our understanding of how to address this disease. Methods We searched 11 databases and collected primary peer reviewed articles on noma in all languages, the final search was conducted on 24th August 2021. The oldest manuscript identified was from 28th March 1843 and the most recently published manuscript was from 3rd June 2021. Search terms included cancrum oris and noma. Data was extracted using a standardised data extraction tool and key areas of interest were identified. The Preferred Reporting Items for Systemic review and Meta-Analyses requirements were followed. Results The review included 147 articles, the majority of the studies (n = 94, 64%) were case reports. Most manuscripts (n = 81, 55%) were published in the 2000s, 49 (33%) were from the 1900s and 17 (12%) from the 1800s. The main areas of interest identified were the history and epidemiology of the disease, noma’s clinical progression and aetiology, treatment regimens, mortality rates and the risk factors for the development of noma. Conclusions Noma has been reported in the literature for hundreds of years; however important gaps in our understanding of the disease remain. Future research should focus on determining the burden and distribution of disease; the true mortality rate, pathogenic cause(s) and the factors that influence prognosis and outcomes after treatment.

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Section: Resultsmentioning

confidence: 99%

Noma (cancrum oris): A scoping literature review of a neglected disease (1843 to 2021)

Farley

Mehta

Srour³

et al. 2021

PLoS Negl Trop Dis

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“…Our study adds to the existing noma literature and is unique as we have followed up with the patients over a longer period (18 mo) in comparison with other studies, which had follow-up periods of 2–6 wk. 8 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

Outcomes at 18 mo of 37 noma (cancrum oris) cases surgically treated at the Noma Children's Hospital, Sokoto, Nigeria

Farley

Amirtharajah

Winters

et al. 2020

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Noma is a rapidly progressing infection of the oral cavity frequently resulting in severe facial disfigurement. We present a case series of noma patients surgically treated in northwest Nigeria. Methods A retrospective analysis of routinely collected data (demographics, diagnosis and surgical procedures undergone) and in-person follow-up assessments (anthropometry, mouth opening and quality of life measurements) were conducted with patients who had surgery >6 mo prior to data collection. Results Of the 37 patients included, 21 (56.8%) were male and 22 (62.9%) were aged >6 y. The median number of months between last surgery and follow-up was 18 (IQR 13, 25) mo. At admission, the most severely affected anatomical area was the outer cheek (n = 9; 36.0% of patients had lost between 26% and 50%). The most frequent surgical procedures were the deltopectoral flap (n = 16; 43.2%) and trismus release (n = 12; 32.4%). For the eight trismus-release patients where mouth opening was documented at admission, all had a mouth opening of 0–20 mm at follow-up. All patients reported that the surgery had improved their quality of life. Conclusions Following their last surgical intervention, noma patients do experience some improvements in their quality of life, but debilitating long-term sequelae persist.

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“…33,39 Under other surgical conditions, combinations of two simultaneous free flaps for the outer and inner cheek linings or custom-made prelaminated flaps might be considered. 31,38,40 In our opinion, these approaches should not be used under the usual West African medical conditions. A multistage procedure, such as prelamination, represents a definitive disadvantage in this region, because follow-up monitoring, patient compliance, and repetitive plastic surgical treatment are problematic in these Third World countries.…”

Section: Resultsmentioning

confidence: 94%

“…20,29,31 On the basis of the knowledge of very experienced workgroups 20,29,31 and our own results on three Interplast missions, we think that two principles should be followed in major noma reconstruction cases. First, flap tissue is required for the outer and inner linings.…”

mentioning

confidence: 97%

Noma: Experiences with a Microvascular Approach under West African Conditions

Giessler

Schmidt

2003

Plastic and Reconstructive Surgery

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Noma (cancrum oris) is a serious ulcerating disease that generally begins in the gingival sulcus of children. One of the main areas of prevalence today is West Africa. If noma is survived, it results in disfiguring midfacial defects and intense scarring. Oral incompetence is often combined with trismus resulting from scar formation or bony fusion between the maxilla and the mandible. Reconstructive approaches with pedicled flaps from the head or shoulder area for closure of the outer defects have been prone to donor-site complications or have not properly addressed the trismus, leading to high recurrence rates. During three West African Interplast missions, a single-stage procedure was developed for reconstruction of the inner and outer linings of the oral, nasal, and paranasal cavities, with restoration of jaw function. The procedure consists of radical scar excision, placement of an external distractor for mouth opening, and primary closure of the defect with a folded free parascapular flap for full-thickness coverage. Twenty-three patients with various noma-related defects were treated with this procedure; two cases are described in detail. This combined treatment can be a safe successful procedure for patients with noma, especially those with severe soft-tissue destruction and profound trismus, even under demanding surgical conditions.

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The prefabricated superficial temporal fascia flap in noma surgery

Cited by 13 publications

References 14 publications

Noma (cancrum oris): A scoping literature review of a neglected disease (1843 to 2021)

Noma (cancrum oris): A scoping literature review of a neglected disease (1843 to 2021)

Outcomes at 18 mo of 37 noma (cancrum oris) cases surgically treated at the Noma Children's Hospital, Sokoto, Nigeria

Noma: Experiences with a Microvascular Approach under West African Conditions

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