Médecins Sans Frontières, Noma Children's Hospital, Sokoto, Nigeria.
Department of Public Health Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
Trans R Soc Trop Med Hyg. 2020 Nov 6;114(11):812-819. doi: 10.1093/trstmh/traa061.
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.
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.
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.
Following their last surgical intervention, noma patients do experience some improvements in their quality of life, but debilitating long-term sequelae persist.
坏疽性口炎是一种口腔迅速进展性感染，常导致严重的面部毁容。我们报告了在尼日利亚西北部接受手术治疗的坏疽性口炎患者的病例系列。
对接受手术治疗>6 个月且在数据收集前接受了面对面随访评估（人体测量、张口度和生活质量测量）的患者进行了回顾性分析，收集了常规收集的数据（人口统计学、诊断和手术程序）。
37 例患者中，21 例（56.8%）为男性，22 例（62.9%）年龄>6 岁。末次手术与随访之间的中位数时间为 18（IQR 13，25）个月。入院时，最严重受累的解剖区域为外颊（9 例；36.0%的患者损失了 26%至 50%）。最常见的手术程序是三角肌皮瓣（16 例；43.2%）和张口松解术（12 例；32.4%）。对于 8 例接受张口松解术且在入院时记录了张口度的患者，所有患者在随访时的张口度均为 0-20mm。所有患者均报告手术改善了他们的生活质量。
在最后一次手术干预后，坏疽性口炎患者确实在生活质量方面有所改善，但仍存在致残的长期后遗症。
