Pattern of tissue destruction among patients diagnosed with cancrum oris (Noma) at a Northwestern Nigerian Hospital, Sokoto

Abstract

Background: Cancrum oris is a debilitating and rapidly progressive gangrenous disease. It is life-threatening and results in severe devastation. Tissue loss constitutes a formidable cause of morbidity in patients and also poses an enormous challenge to a reconstructive surgeon. This study aims to describe the pattern of tissue loss among patients with cancrum oris at our center. Methods: A review of the data of patients treated for cancrum oris at Noma Children Hospital, Sokoto, Nigeria, from December 1999 to 2011, was done. Data on the age, gender, and pattern of tissue loss were retrieved. The pattern of tissue loss was assessed anatomically and clinically. Analysis of data was done using SPSS (IBM SPSS Statistics for Windows Version 20 [Armonk, NY: IBM Corp]). Results: A total of 159 cases of cancrum oris were included in this study. The age range was 1–33 years with a mean (± standard deviation) of 3.5 (3.23) years. A male/female ratio of 1:1.2 was observed. A total of 425 sites were affected in 159 patients. In 109 (68.6%) patients, only soft tissue involvement was seen, while a combination of soft and hard tissue destructions was observed in 50 (31.4%) patients. The most frequently affected site was the cheek, 268 (63.1%), followed by the lips, 106 (66.7%). The nose was affected in 40 (25.2%) patients. Osseous involvement was observed in 50 (7.6%) patients. Conclusion: Cancrum oris, though considered to be a rare disease, continues to constitute a grievous cause of orofacial tissue loss and consequent morbidity in our environment.