Treatment of severe microstomia caused by massive fungal destruction of the lips: clinical report.

JL he literature contains many reports about the care and prevention of microstomia caused by electrical, thermal, and caustic burns of the lip and perioral areas. Treatment for the prevention of microstomia is similar regardless of the cause. These traumas to the oral and perioral tissue usually occur between 10 months and 4 years of age. The immediate problems are tissue damage, hemorrhage, infection, nutritional deficiency, and scar adhesions. The long-term outcome, (severe contracture or microstomia) results in problems associated with development of the orofacial structures, oral hygiene, dental treatment, facial expression, speech, and general anesthesia administration. Use of an appliance to prevent rniscrostomia is indicated when there is unilateral or bilateral damage to the commissures of the lips. The appliance is inserted immediately after the patient is stable and preferably before the eschar sloughing that usually occurs within the first two weeks. It is used to prevent commissure adhesions, scar contracture, and to prevent or minimize the need for surgical procedures. The appliance is worn 24 hours a day except when the child eats or the wound is cleaned. The length of wearing time depends on the age and cooperation of the child and the severity of oral damage. This time period may range from three months to two years after the initial trauma. ' ' This clinical report relates the treatment of a patient with severe microstomia resulting from a massive oral fungal infection.