Postburn Microstomia: Anatomy and Elimination with Trapeze-Flap Plasty
After facial burns, the commissural mucosa remains undamaged and scars form on the external surface of the mouth corners where the scar fold forms, narrowing the oral orifice and causing microstomia. The lips grow together, and the angles become obliterated. A small oral opening restricts oral intake, routine oral hygiene, dental procedures, and intubation in case of surgery. According to most authors, the scar tissue must be removed from the commissural angle; the wounds are closed with Y-V plasty or with the use of mucosal flap variations. Scars located in the corner of the mouth orifice have a trapezoid surface deficit and their removal increases the defect. Therefore, we developed a method that consists of contracture release by scar dissection with a Y-incision up to the normal size of the orifice. After opening the mouth, a trapezoid wound appeared (scar surface deficit) and this was covered with the trapezoid mucosal flap. This technique and the excellent results achieved with it are presented in this chapter.