Prosthodontic rehabilitation and management of microstomia patient presents challenges at all stages during prosthesis fabrication; from making primary impressions to the prostheses insertion. These patients have reduced mouth opening, and hence it can be extremely challenging to make impressions and to fabricate dentures using the conventional methods. The present case report describes prosthodontic management of a partially dentate patient with microstomia that developed secondary to surgical resection and radiation therapy of head and neck cancer. A simplified novel approach has been advocated using the patient’s existing metal removable partial denture as a key in master cast preparation.
Microstomia

It is difficult to make impression and fabricate conventional dentures for patients with microstomia and flat ridge. This is a case report of 53-year-old female with limited mouth opening (25 mm) who had been wearing denture for 7 years and which was recently broken. Close mouth with suction impression method was used. Proper diagnosis and appropriate set of procedures and methods were needed for this patient. The conventional complete denture fitted with closed mouth method for this condition resulted in retentive and stable denture which was inserted and removed easily.
Microstomia ; Denture, Complete

PURPOSE: To report a patient with Freeman-Sheldon syndrome with blepharophimosis. METHODS: A 4-year-old girl with congenital facial abnormalities consistent with Freeman-Sheldon syndrome presented with complaints of blepharophimosis. The characteristic features of microstomia, down-slanting palpebral fissure, blepharoptosis, and telecanthus were also found. Y-V epicanthoplasty and levator aponeurosis resection were performed. RESULTS: Surgical intervention to correct ptosis and telecanthus led to initially fair cosmetic results, but one month later an unexpected decrease in interpalpebral fissure height was noted. CONCLUSIONS: Freeman-Sheldon syndrome with blepharophimosis is very rare. It was necessary to correct blepharoptosis, telecanthus, and blepharophimosis in the oculoplastic service in this case.
Blepharophimosis ; Blepharoptosis ; Child, Preschool ; Female ; Humans ; Microstomia

The Freeman-Sheldon syndrome (FSS) is a rare congenital myopathy. Main manifestations are "whistling face", camptodactyly with ulnar deviation of the finger and talipes equinovarus. Myopathic fibrotic circumoral musculature result in microstomia with the characteristic protruding pursed "whistling lip" and mandibular and laryngeal development may also be abnormal. Thus the patients with FSS are expected to difficult intubation and the use of muscle relaxant should not be expected to improve intubating condition. We report a children with the Freeman-Sheldon syndrome who was intubated with fiberoptic laryngoscope and discuss anesthetic consideration.
Child ; Clubfoot ; Fingers ; Humans ; Intubation* ; Laryngoscopes ; Microstomia ; Muscular Diseases

microstomia using the Converse flap which yielded a satisfactory outcome.]]>
Facial Expression ; Humans ; Lip ; Microstomia ; Mouth ; Surgery, Oral

BACKGROUND: The lips have an asethetic and functional importance. There are various types of lip defects, and these are mainly due to tumor excision. Although there are numerous techniques available to repair the lips, no universal reconstruction method is presently available, and reconstruction of lip defects are inherently difficult. OBJECTIVE: To report surgical reconstruction results of lip defects. METHOD: Our study involved eleven patients, who had visited our dermatologic surgery clinic between 1995 and 2003, and had been histopathologically diagnosed as having either a basal cell carcinoma or squamous cell carcinoma on the lips. The medical records were reviewed, and clinical features, surgical methods, and cosmetic and functional results were evaluated. RESULTS: Wedge resection, resection with W-plasty, the subcutaneous pedicle flap, and dual mucosal flap technique were used to repair lip defects surgically. The vermilion border was aligned well in all the patients, and a post-operative scar was not apparent. However, a microstomia developed in one patient. CONCLUSION: The dermatologic surgeon should be familiar with various reconstruction options for lip defects. An appropriate choice depends on the size, location and depth of the defect. Specific functional and aesthetic aspects of the lips should be taken into account when planning and performing an operation.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cicatrix ; Dermatologic Surgical Procedures ; Humans ; Lip* ; Medical Records ; Microstomia

Freeman-Sheldon syndrome is a rare syndrome first described by Freeman and Sheldon in 1938. Features of the syndrome include a characteristic facial appearance with multiple skeletal anomalies due to abnormal muscle tone. Since its first description, the syndrome has been called the Freeman-Sheldon syndrome, Windmill-Vane-Hand syndrome and Whistling-Face syndrome. The diagnosis may be made clinically during the first year of life. The majority of reported cases of Freeman-Sheldon syndrome are autosomal dominantly inherited but a clinically indistinguishable autosomal recessive type has been reported. We experienced a case of Freeman-Sheldon syndrome in a newborn who presented with prominent supraorbital ridge, sunken eyes, telecanthus, short nose, long philtrum, and marked microstomia. The neck was short. The hands showed symmetrically clenched fingers with camptodactyly and feet demonstrated bilateral talipes equinovarus. His father has a slight microstomia and contractures of both fingers.
Clubfoot ; Contracture ; Diagnosis ; Fathers* ; Fingers ; Foot ; Hand ; Humans ; Infant, Newborn ; Lip ; Microstomia ; Neck ; Nose

The Abbé-Estlander flap surgery is a cross-lip procedure that is valuable in repairing a defect on the lower lip using a full-thickness flap, consisting of the skin, muscle and mucosa, from the upper lip. As usefulness and practicality of the flap in reconstruction of lower lip surgical defects in Asian ethnicity have not been documented, the authors present a case of successful lower lip reconstruction with a staged, Abbé-Estlander lip switching flap with commissuroplasty as an illustrative example. A 71-year-old male has presented with an ulcerating lip nodule in the middle one third of the lower lip, measuring about 1.5×2 cm across its long and short axes. Wide excision of the tumor was followed by delineation of the triangular Abbé-Estlander flap from the upper lip, in which the medial hinge point of the base was chosen as the pedicle. Then, the flap elevation was carried out from the lateral commissure and then was transferred into the lower lip defect. Three weeks later, commissuroplasty was performed to correct the rounding at the new commissure. The patient is currently performing his daily activities with no apparent compromise in orbicularis oris strength or oral continence. Given the size of the primary defect and the flap-to-defect ratio of size, the degree of microstomia was acceptable. Even with other myriad of reconstructive options at surgeons' disposal, the Abbé-Estlander lip-switching flap is a reliable, and less morbid method of lower lip reconstruction for Asian surgical candidates. The authors illustrate an exemplary case in which a relatively large lower lip defect was successfully repaired using an upper lip flap of a significantly smaller size in an Asian subject of advanced age, without any remarkable long term sequelae which have traditionally been associated with the trans-oral lip switching flap technique.
Aged ; Asian Continental Ancestry Group ; Humans ; Lip Neoplasms ; Lip* ; Male ; Methods ; Microstomia ; Mucous Membrane ; Skin ; Ulcer

The Congenital Ulnar Drift of the fingers is a relatively uncommon and has symmetrical malformations of hand, face and foot characterized by MP joint flexion contracture and ulnarward deviation of the fingers and microstomia, In tarsal deformity, there are clubfoot and congenital vertical talus with rocker bottom deformity. In treatment, the report of the surgical treatment was rare. We experienced congenital ulnar drift of fingers in 2 patients in one family, which were treated by dome resection corrective osteotomy of the metacarpals. Therefore remarkable symptomatic improvement was obtained.
Clubfoot ; Congenital Abnormalities ; Contracture ; Fingers ; Foot ; Hand ; Humans ; Joints ; Metacarpal Bones ; Microstomia ; Osteotomy ; Talus

Objective: To investigate the clinical effects of ultra-pulsed fractional carbon dioxide laser (UFCL) in the treatment of mild to moderate microstomia after burns. Methods: A retrospective observational study was conducted on 19 patients with mild to moderate microstomia after burns who were admitted to Inner Mongolia Baogang Hospital from January 2018 to January 2022, including 15 males and 4 females aged (35±14) years. Patients had an average course of 71 d of microstomia, with 8 cases of moderate microstomia and 11 cases of mild microstomia. All the patients received UFCL treatment every 2-3 months until the microstomia was corrected or the treatment bottleneck was reached. The times of UFCL treatment for patients and the time interval from the last treatment to the last follow-up were recorded. Before the first treatment and at the last follow-up, the opening degree of mouth (finger measurement method), oral gap width, and the distance between the upper and lower incisors during mouth opening were recorded. Before the first treatment and at the last treatment, the new Vancouver scar scale (VSS) was used to evaluate the scar. At the last follow-up, the degree of satisfaction was evaluated by the Likert 5 scale by the patients themselves, and the satisfaction ratio was calculated; the adverse reactions such as pigmentation, blisters, infection, and persistent erythema in the treatment area were counted. Data were statistically analyzed with Mann-Whitney rank sum test or paired sample t test. Results: Patients received UFCL treatment of 3 (2, 6) times. The interval from the last treatment to the last follow-up was 26 months at most and 4 months at least. At the last follow-up, the opening degree of mouth of patients was significantly improved than that before treatment (Z=4.68, P<0.01). At the last follow-up, the oral gap width of patients was (35±6) mm, and the distance between upper and lower incisors during mouth opening was (3.2±0.4) cm, which was significantly improved compared with those before treatment (with t values of 10.73 and 18.97, respectively, P<0.01). The VSS score after the last treatment was 4.1±1.6, which was significantly better than that before treatment (t=22.96, P<0.01). At the last follow-up, the satisfaction ratio of patients with treatment was 18/19, and no pigmentation, blisters, infection, persistent erythema, and other adverse reactions of all patients in the treatment area occurred, however, one of the patients reported that the disease recurred about half a year after treatment. Conclusions: UFCL is an effective method for treating mild to moderate microstomia after burns, with which patients are highly satisfied, and it is worth of further study and promotion.
Blister ; Burns/therapy* ; Cicatrix/therapy* ; Female ; Humans ; Lasers, Gas/therapeutic use* ; Male ; Microstomia ; Treatment Outcome