Department of Anaesthesia, Royal United Hospital Bath NHS Trust, Combe, Park Bath, UK, BA1 3NG.
Anesth Analg. 2013 Jul;117(1):211-8. doi: 10.1213/ANE.0b013e3182908e6f. Epub 2013 Jun 3.
Noma (cancrum oris) is a disease of poverty and malnutrition, which predominantly affects children younger than 10 years in developing countries. Although the majority of sufferers die of sepsis at the time of the initial infection, or of subsequent starvation due to severe trismus and an inability to eat, a small minority of patients survive and require reconstructive surgery for severe facial scarring and deformity. These patients present significant problems to the anesthesiologist with regard to airway management. We present a series of 26 patients undergoing primary and subsequent reconstructive surgery, with particular focus on airway management. We show that airway management, while challenging, can be performed safely and successfully by using individualized airway plans but may require advanced techniques and equipment. Traditional tests focusing on the anterior/superior airway are helpful in assessing patients with facial deformity due to noma.
坏疽性口炎（亦称口咽部坏死性溃疡）是一种与贫困和营养不良相关的疾病，主要影响发展中国家 10 岁以下的儿童。尽管大多数患者在初次感染时因败血症死亡，或因严重牙关紧闭和无法进食而继发饥饿，但少数患者存活下来，需要进行严重面部瘢痕和畸形的重建手术。这些患者给麻醉师在气道管理方面带来了重大挑战。我们报告了一系列接受初次和后续重建手术的 26 例患者，重点介绍了气道管理。我们表明，气道管理虽然具有挑战性，但可以通过使用个体化的气道计划安全且成功地进行，但可能需要先进的技术和设备。针对因坏疽性口炎导致面部畸形的患者，传统的侧重于前/上气道的检查有助于评估。
