International Journal of Oral and Maxillofacial Surgery
Clinical PaperReconstructive SurgeryLong-term results of trismus release in noma patients
Section snippets
Materials and methods
To recruit patients, the NCHS database was searched. Files with the terms ‘noma’ and ‘trismus’ were identified and the following data collected: address; gender; age; age of onset; date of admission; stage of noma; team number; information on the operations; pre- and postoperative mouth opening; postoperative physiotherapy; and date of discharge. The NOITULP classification, introduced by Marck in 1998, was used to determine the extent of defects in the noma patients10. In this classification, ‘T
Results
Two hundred and six files in the NCHS database contained the terms ‘noma’ and ‘trismus’, but only 130 files were present in the hospital and could be reviewed. Of these, 63 patients fulfilled the selection criteria and were visited in the field. In a journey of 1900 miles to 45 villages, 36 patients were found and included in the study. The remaining nine patients had given incorrect addresses, were not present at the time of the visit or were not traceable. The 18 people who were not visited
Discussion
Since 1996, teams of specialists have travelled to NCHS in Sokoto, Nigeria, to operate on patients who have survived noma. One of their objectives is the release of trismus. The surgeons thought that the short-term results of the release were successful but the long-term effect is unknown. This study was set up to aid future evidence-based treatment of trismus in noma patients.
Overall, the long-term result of trismus release is extremely poor. Only 39% of patients showed an improvement in the T
Competing interests
None declared.
Funding
Funded by Departmental sources of Department of Oral and Maxillofacial Surgery, Oral and Craniomaxillofacial Surgery, Radboud University Nijmegen, The Netherlands and Foundation Nijmegen University Fund, Radboud University Nijmegen, The Netherlands.
Ethical approval
Not required.
Acknowledgements
The authors specially thank Dr Adeniyi Semiyu Adetunji for his effort and support in accomplishing the research in Nigeria, Alhaji Nasiru Uba for translating and arranging the accommodation in the field, Abdullahi Hassa for driving us around through the rough areas for about 1900 miles and Abubakar Umar Gagi for searching the files in the hospital.
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