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Innovative Techniques in Noma Reconstructive Surgery

  • Chapter
Innovations in Plastic and Aesthetic Surgery

Abstract

Noma (orofacial gangrene, necrotizing ulcerative stomatitis, stomatitis gangrenosa, or cancrum oris) is a devastating orofacial gangrene that occurs almost uniquely among children in less developed countries, during the weaning period [5, 6, 10, 11, 37, 38]. The most important risk factors are: poverty, malnutrition, a compromised immune system, poor oral hygiene and a lesion of the gingival mucosal barrier, as well as an unidentified bacterial factor [5]. The disease has an estimated global yearly incidence of 25,600-140,000 cases and a mortality rate of approximately 90% [13]. Patients who survive the acute noma stages generally suffer from its sequelae, including serious facial disfigurement, trismus and ankylosis, oral incontinence, and speech problems. This is why noma has been called “the face of poverty” [10, 26]. The complex facial defects can be classified with the NOITULP system, as proposed by Marck in 1998 [27]. NOITULP is an acronym of Nose, Outer lining, Inner lining, Trismus, Upper lip, Lower lip and Particularities. Every itemis validated and given a score from 0 to 4 (Table 22.1).

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Author information

Authors and Affiliations

  1. 926 Department of Plastic Surgery, Radboud University Medical Centre, Reinier Postlaan 4, PB 9101, 6500 HB, Nijmegen, The Netherlands

    E. H. M. Hartman MD, PhD

  2. 590 Department of Oral & Craniomaxillofacial Surgery, Radboud University Medical Centre, PB 9101, 6500 HB, Nijmegen, The Netherlands

    P. A. Van Damme DMD, MD, PhD

  3. Department of Plastic Surgery, Helsinki University Central Hospital, Pl 266, 00029, Hyks, Finland

    S. H. H. Suominen MD, PhD

Authors
  1. E. H. M. Hartman MD, PhD
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  2. P. A. Van Damme DMD, MD, PhD
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  3. S. H. H. Suominen MD, PhD
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Editor information

Editors and Affiliations

  1. Klinik für Plastische und Ästhetische Hand- und Wiederherstellungschirurgie, Caritas-Krankenhaus St. Josef in Regensburg, Landshuter Straße 65, 93053, Regensburg, Germany

    Marita Eisenmann-Klein M.D. (General Secretary of the International Confederation for Plastic, Reconstructive and Aesthetic Surgery and Direktorin) (General Secretary of the International Confederation for Plastic, Reconstructive and Aesthetic Surgery and Direktorin)

  2. IQUAM (International Committee for Quality Assurance and Medical Devices in Plastic Surgery), Theatinerstraße 1, 80333, München, Germany

    Constance Neuhann-Lorenz M.D. (Fachärztin für Chirurgie Fachärztin für Plastische und Ästhetische Chirurgie und President) (Fachärztin für Chirurgie Fachärztin für Plastische und Ästhetische Chirurgie und President)

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© 2008 Springer-Verlag Berlin Heidelberg

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Hartman, E.H.M., Van Damme, P.A., Suominen, S.H.H. (2008). Innovative Techniques in Noma Reconstructive Surgery. In: Eisenmann-Klein, M., Neuhann-Lorenz, C. (eds) Innovations in Plastic and Aesthetic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-46326-9_22

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  • DOI: https://doi.org/10.1007/978-3-540-46326-9_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-46321-4

  • Online ISBN: 978-3-540-46326-9

  • eBook Packages: MedicineMedicine (R0)

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