Reconstructive surgery of corrosive burn sequela of the oral cavity

Abstract

Corrosive lesions of the upper digestive tract are well documented in the literature. Ingestion of acids and sodas may be intentional or accidental. The spectrum of lesions is variable depending on the affected organs, together or separately: oesophagus, stomach and duodenum. The oral cavity is rarely affected. Microstomia, ankyloglossia, teeth loss, vestibular synechia, alteration of facial expression and speech disorder represent the main sequela of caustic lesions reported in the oral cavity. We report the clinical case of 27-year-old woman who was a victim of burns of the oral cavity due to the accidental ingestion of a very corrosive descaling agent in October 2008. She underwent two prior surgeries at another department without any improvement. When she presented at our department, she was very weak suffering of a severe anaemia and weighing 35 kg. Situation that was incompatible with survival. After a period of reanimation and blood transfusions, we performed under general anaesthesia and intubation with nasofibroscopy a reconstructive surgery after tissue debridement using a pedicled latissimus dorsi flap to obtain a satisfactory mouth opening. The therapeutic strategy and postoperative care are discussed in this work.