Erdmann D, Schierle H, Sauerbier M, Germann G, Lemperle G
Abteilung für Verbrennungen, Plastische und Handchirurgie, BG-Unfallklinik Ludwigshafen.
Chirurg. 1998 Nov;69(11):1257-62. doi: 10.1007/s001040050565.
Noma is an ulcerative-necrotizing gingivo-stomatitis eventually leading to severe destruction of the midface, including lips and cheek, maxilla/mandible, nose and rarely the orbit. The defects are usually unilateral. Children from economically underdeveloped countries are predominantly affected. Medically untreated the disease has a high mortality rate, which can be dramatically lowered by adequate antibiotic therapy started in time. Predisposing factors include malnourishment, immunosuppression, and poor oral hygiene. Forty-eight noma patients were surgically treated in Sokoto, Nigeria during October 1997 by an Interplast Germany team sponsored by AWD Stiftung Kinderhilfe. Interdisciplinary surgical strategies and results, e.g. ankylosis release, local flap coverage and 12 pedicled musculocutaneous latissimus dorsi island flaps, as well as a noma classification (NOMAC), are presented.
坏疽性口炎是一种溃疡性坏死性龈口炎，最终会导致面部中部严重破坏，包括嘴唇、脸颊、上颌骨/下颌骨、鼻子，很少累及眼眶。缺损通常为单侧。经济欠发达国家的儿童受影响最为严重。若不进行医学治疗，该病死亡率很高，及时开始适当的抗生素治疗可显著降低死亡率。诱发因素包括营养不良、免疫抑制和口腔卫生差。1997年10月，德国国际整形组织团队在德国儿童救助基金会的赞助下，在尼日利亚索科托对48名坏疽性口炎患者进行了手术治疗。文中介绍了多学科手术策略及结果，如关节强直松解、局部皮瓣覆盖和12块带蒂背阔肌岛状肌皮瓣，以及一种坏疽性口炎分类法（NOMAC）。
