caa a22 4500 46321076X CHVBK 20180405153140.0 cr unu---uuuuu 170326e20071201xx s 000 0 eng 10.1007/s00238-007-0170-6 doi (NATIONALLICENCE)springer-10.1007/s00238-007-0170-6 Surgical treatment of a severe microstomia developed following leucocytoclastic vasculitis [Elektronische Daten] [Serhan Tuncer, Gustavo Bello-Rojas, Mark Blake, Ian Jackson] Narrowing of the oral opening, also known as microstomia, is a rarely seen condition. It can develop iatrogenically after wide excision of perioral tumors with subsequent reconstruction or can be a component of severe scleroderma. In the pediatric population, exposure to caustic agents and subsequent scarring is another cause. This situation can cause problems in feeding, articulation, and oral hygiene. Most of the cases reported have been moderately affected; these require non-surgical treatment or a small procedure, such as a comissuroplasty, to provide an adequate oral opening. A case of severe microstomia developed as a result of a rare condition known as leucocytoclastic vasculitis is presented. A boy aged 2 1/2years was admitted complaining of severely restricted mouth opening. This resulted from a complicated vasculitic illness, the etiology of which was unknown. The condition subsequently caused necrosis and gangrene with autoamputation of the toes of the right foot, the distal two phalanges of the right index finger, and the distal phalanx of the left ring finger. In addition to the limb problems, he also developed a similar situation around the left side of his mouth. For 21days, he was treated with antibiotics and antifungal medication. He also had serial skin biopsies, which showed only a leucocytoclastic vasculitis. The initial examination revealed significant scarring around the mouth with a severe microstomia. His mouth opening area was restricted to 1cm. The surgical correction consisted of opening the mouth using full-thickness incisions on both oral commissures to slightly overcorrect the situation. A moderately extensive dissection was carried out to identify the orbicularis muscles and to allow reconstruction of the muscular element of the commissures. Once the functional area of the commissures had been reconstructed, mucosal flaps were developed and advanced to form the red margin. After 7years of follow-up, his mouth opening remains satisfactory, and he had been able to have extensive orthodontic treatment. Springer-Verlag, 2007 Microstomia nationallicence Leucocytoclastic vasculitis nationallicence Oral stenosis nationallicence Tuncer Serhan Department of Plastic, Reconstructive and Aesthetic Surgery, Gazi University Faculty of Medicine, Ankara, Turkey aut Bello-Rojas Gustavo Institute for Craniofacial and Reconstructive Surgery, 16001 W. Nine Mile Rd., Third Floor Fisher Center, 48075, Southfield, MI, USA aut Blake Mark Institute for Craniofacial and Reconstructive Surgery, 16001 W. Nine Mile Rd., Third Floor Fisher Center, 48075, Southfield, MI, USA aut Jackson Ian Institute for Craniofacial and Reconstructive Surgery, 16001 W. Nine Mile Rd., Third Floor Fisher Center, 48075, Southfield, MI, USA aut European Journal of Plastic Surgery Springer-Verlag 30/4(2007-12-01), 183-187 0930-343X 30:4<183 2007 30 238 https://doi.org/10.1007/s00238-007-0170-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00238-007-0170-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tuncer Serhan Department of Plastic, Reconstructive and Aesthetic Surgery, Gazi University Faculty of Medicine, Ankara, Turkey aut NATIONALLICENCE 700 1- Bello-Rojas Gustavo Institute for Craniofacial and Reconstructive Surgery, 16001 W. Nine Mile Rd., Third Floor Fisher Center, 48075, Southfield, MI, USA aut NATIONALLICENCE 700 1- Blake Mark Institute for Craniofacial and Reconstructive Surgery, 16001 W. Nine Mile Rd., Third Floor Fisher Center, 48075, Southfield, MI, USA aut NATIONALLICENCE 700 1- Jackson Ian Institute for Craniofacial and Reconstructive Surgery, 16001 W. Nine Mile Rd., Third Floor Fisher Center, 48075, Southfield, MI, USA aut NATIONALLICENCE 773 0- European Journal of Plastic Surgery Springer-Verlag 30/4(2007-12-01), 183-187 0930-343X 30:4<183 2007 30 238 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer