• 대한두개안면성형외과학회지
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• 제21권2호
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• pp.119-122
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• 2020

Stevens-Johnson syndrome (SJS) is a rare disease in which extensive toxic epidermolysis occurs after medication. Skin and mucous membranes are involved in about 90% of SJS cases, and webbing of mouth corners (microstomia) may occur when they are affected. Few reports have been issued on microstomia in SJS, and no consensus has been reached regarding treatment methods, timings, or results. We encountered a case of microstomia following SJS after ofloxacin medication in a 22-year-old woman treated by commissuroplasty using a lozenge-shaped excision. We present an appropriate correction method and surgical timing for microstomia following SJS.

• 대한두개안면성형외과학회지
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• 제25권3호
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• pp.105-115
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• 2024

The mouth, located in the lower third of the face, is a uniquely visible structure. It serves as a vital organ both aesthetically and functionally, playing a key role in speech, expression, and fundamental oral functions. Consequently, any alterations or defects in its shape, due to various causes, can lead to aesthetic and functional deficiencies. These issues may also result in challenges with social interactions and a decrease in confidence. In cases of microstomia, various surgical approaches are proposed based on the location, extent, shape, and cause of the defect, leading to numerous case reports. Plastic surgeons are proficient in oral reconstruction; however, cases of microstomia are relatively rare, which reduces their familiarity and interest in these cases. Additionally, preferences for oral size and shape vary according to factors such as geographical region and ethnicity, further complicating the functional definition of microstomia. Therefore, both subjective patient and physician judgments play crucial roles in the diagnosis and treatment of microstomia, as these may vary depending on individual and societal aspects. This review aims to classify the various causes and definitions of microstomia, as well as its non-surgical and surgical treatment options, with the goal of the treatment of this condition.

• 대한치과의사협회지
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• 제56권11호
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• pp.616-621
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• 2018

This clinical case highlights the failure of long length implants, and the prosthodontic procedures necessary to rehabilitate the maxillary dentition of a patient with microstomia. The integrated digital technology of intra-oral scanning, computer-aided design, and three-dimensional printing can provide an alternative method to make conventional impressions for patients with microstomia who cannot insert the appropriate tray in their mouths.

• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.161-165
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• 2020

Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion: Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권3호
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• pp.182-188
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• 1993

A technical refinement for oral commissure reconstruction is presented. The oral commissure has an important role in oral sphincteric function. Once lost, the oral commissure is very difficult to restore and therefore, reconstruction of the oral commissure requires prevention of this function as well as prevention of microstomia. Trauma and tumor excisions are the most frequent reasons that will necessitate reconstruction of the oral commissure. Direct approximation of the wound margins after resection of the corner of the mouth could easily induce microstomia and difficulty in opening. Thus case presented here deals with distortion of noraml mouth angle and acquired microstomia due to burn and tissue deface following shotgun and explosive wounds. The a mucosal flap approach was used to rehabilitate a natural looking mouth angle showing satisfactory results function and esthetic wise.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.543-547
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• 2007

The lips and corners of the mouth are not only important for appearance but are also essential for facial expression, speech, and nutrition. Defects in these areas can be caused by congenital clefts of the lip and face, trauma, infection, cysts, and excision of benign or malignant tumors. Numerous techniques have been introduced for reconstruction of the lips and corners of the mouth, and in particular, techniques such as the Kazanjian Roopenian I and II, Converse method, Zisser method, Platz and Wepner method. Gillies and Millard method are commonly utilized for elongation and reconstruction of the mouth corner. Few reports exist in the oral and maxillofacial surgery literature regarding correction of microsomia and reconstruction of the corners of the mouth. As such, the authors report a case of the corners of the mouth elongation in a patient with burn-induced microstomia using the Converse flap which yielded a satisfactory outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권4호
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• pp.380-385
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• 2008

양측성 구순구개열을 가진 16세 여자 환자가 소구증과 구순열비변형으로 인하여 개구 제한과 심미적 문제를 주소로 내원하였다. 병력에서 구순성형술, 구개성형술 그리고 이차구순비성형술을 받았으며, 임상 소견에서 상순과 하순이 매우 작고 입술의 폭은 40 mm 정도로 짧았으며 최대 개구량은 20 mm였다. Converse의 협점막 외전 피판을 이용한 양측성 구각성형술을 시행하였으며 수술 후 입술의 폭은 60 mm로 증가하였다. 수술 1년 경과 후 입술의 폭은 54mm로 약 6 mm 정도 회귀되었고, 그 외에 별다른 문제점 없이 심미적, 기능적으로 양호한 결과를 보였다. 협점막 외전 피판을 이용한 양측성 구각성형술은 입술의 폭과 크기를 증가시켜주고 입술의 외관을 개선하여 소구증의 외과적 교정에 적절한 술식임을 알 수 있었다.

• 대한장애인치과학회지
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• 제10권2호
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• pp.101-105
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• 2014

Moebius syndrome is a rare, congenital neurological disease involving facial paralysis and limitation of eye movements. It results from maldevelopment of the sixth and seventh cranial nerves. Dental features of this syndrome include micrognathia, microstomia, tongue deformity, cleft palate, hypoplasia of the teeth, and congenital missing teeth. A 7-year-old female with Moebius syndrome was referred from a local dental clinic for caries treatment. She presented with facial paralysis and microstomia. Oral findings included multiple caries with enamel hypoplasia, congenital missing teeth, and tongue deformity. Dental treatments including restorative and preventive procedures were performed. Oral findings and management aspects of Moebius syndrome for this case are discussed. Early evaluation and multidisciplinary care are needed for children with Moebius syndrome.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.358-365
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• 1996

Deep burns of the face & lips often lead to scarring and contraction of the circum-oral tissues with a marked reduction in the size of the oral aperture. Such burns most commonly caused by electrical contact, for example, children sucking electric plugs, or as a result of chemical burns and the exposture to flame. Once having burns, burned tissue may contract and reduce considerably the size and mobility of the mouth ; therefore bring up the resultant functional disturbance, verbal difficulty, even digestive difficulty, and poor appearance, which fall into difficulty in social acceptability, caused by burns. In our department, 2 patients who were complain of functional limitations and esthetic problem owing to scar contracture, were visited, and we treated this microstomia with scar excision, graft and flap technique, and postoperative intensive physical therapy. We obtained relatively favorable results, thus report this cases with literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권4호
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• pp.267-271
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• 2017

Although it is a rare developmental malformation, van der Woude syndrome is the most common form of syndromic orofacial clefting, accounting for approximately 2% of all cleft cases. The lower lip pits with or without a cleft lip or palate is characteristic of the syndrome. Findings, such as hypodontia, limb deformities, popliteal webs, ankylogossia, ankyloblepheron, and genitourinary and cardiovascular abnormalities, are rarely associated with the syndrome. This paper reports a rare case of van der Woude syndrome in a 10-year-old male patient with a single median lower lip pit and a repaired bilateral cleft lip and cleft palate that were associated with microstomia, hypodontia, and clubbing of the left foot with syndactyly of the second to fifth lesser toes of the same foot.