Experience of surgical treatment of post-burn oral commissural contracture (Microstomia)

Abstract

Introduction: One of the significant problems of facial burns is post burn oral commissural contracture (Microstomia) occurring as a result of circumferential scarring at the junction between the lips and cheek. It results in aesthetic disfigurement of face and functional impairments like feeding, speech and oral hygiene and difficulty of intubation. Objective: This study aims to share the experience of treatment of microstomia with various methods. Methods: This study comprised of 7 cases of microstomia of variable severity over a period of 10 years. Case number 1, 2 and 3, having severe microstomia, were treated with Converse method of commissuroplasty without waiting for scar maturation. Case number 4 and 5 had moderate severity microstomia, in these patients the correction of the neck contracture was considered as priority and were treated with release of neck contracture and split skin grafting. Case number 6 and 7 had pressing priority of treatment of ectropion which was treated first but unfortunately further the treatment of microstomia was given back seat by the patients. Results: Case number 1 to 5 treated operatively showed significant improvement in mouth opening while case number 6 and 7 who rejected treatment, showed no improvement.Conclusion: Post burn microstomia is infrequent yet important functional condition causing difficulty for feeding and for intubation during anesthesia and hence its correction falls under essential procedure to be done earliest without waiting for scar maturation. Cases which were treated operatively showed significant improvement in mouth opening. In cases that rejected treatment, hence considered as conservatively treated, the results were inferior.