Speech-Language Pathology's Role in Management of Orofacial Contractures After a Facial Burn

Abstract

Purpose: Care of the burn patient continues to advance and requires a comprehensive interdisciplinary team. With advances in medical sciences, mortality has declined for patients with large total body surface area burns, and this has resulted in the need for more hands-on clinical judgment and skill from the speech-language pathologist working with burn survivors. Patients with a facial burn injury pose a special challenge for intervention by the speech-language pathologist. This population calls upon the therapist to be able to assess and treat the limiting effects of orofacial scarring and contractures, as well as speech, language, voice, cognitive, and swallowing disorders. Traditionally, occupational and physical therapists have managed orofacial contractures in this population with methods such as pressure garments, silicone masks, and oral splints. Research and data on cutaneous functional units have shown that occupational and physical therapists require significant time to address the whole body needs of the burn care patient, calling for increased involvement from all professionals especially in larger total body surface area burns. Microstomia and orofacial contractures are a treatment need for the facial burn population and present a collaborative treatment opportunity for the speech-language pathologist. Conclusions: This article will cover the mechanism of a facial burn injury and how it may cause functional impairments that can be directly impacted through early intervention utilizing speech-language pathology services. Best practice in the care of a patient with dermal or full thickness facial burns should include a referral to the speech-language pathologist. There is an opportunity to expand service delivery by the speech-language pathologist in the acute care and outpatient arenas of burn care.