Frequently Performed Surgical Procedures for The Treatment of Noma Cases in Ethiopia

Author(s): Heron Gezahegn Gebretsadik

Background: Noma, a devastating disease that causes severe destruction of facial tissue, necessitates comprehensive surgical intervention to restore functionality and improve the quality of life for affected individuals. This cross-sectional study aimed to determine the most frequently employed surgical procedures for reconstructing Noma defects in Ethiopia.

Methods: A retrospective cross-sectional analysis was conducted on the medical charts of Noma patients from the Facing Africa database. Electronic medical records between 2007 and 2019 at Facing Africa were reviewed to identify the surgical procedures performed for reconstructive purposes. To determine the commonly used procedures, the frequency of each technique was calculated using SPSS Version 2020 in the analysis.

Results: Between 2007 and 2019, Facing Africa conducted a total of 438 surgical procedures to treat 235 cases of Noma. Among these, reconstructive surgery, which includes two or more of the commonly practiced procedures, is the most frequently used technique with 177 procedures. The submental flap ranked second in terms of frequency, with a total of 47 procedures performed. Ankylosis release, aimed at addressing limited jaw movement, was carried out 35 times, while commissuroplasty, focusing on the separation of fused oral commissures, was performed 26 times. The radial forearm free flap was employed 23 times as a viable option for reconstructing facial defects. Coronoidectomy, involving the removal of a portion of the jawbone to improve mouth opening, was performed 11 times. Additionally, debulking, targeting the removal of excessive scar tissue or hypertrophic masses, was carried out 10 times. The Estlander flap, another technique used for lip reconstruction, was utilized 9 times as part of the treatment approach.

Conclusion: This retrospective analysis highlights the most frequently used surgical procedures for reconstructing Noma-related defects in Ethiopia. Reconstructive surgery, submental flap, ankylosis release, and commissuroplasty emerged as the predominant techniques employed. The findings of this study provide valuable insights into the surgical management of Noma cases and can guide healthcare professionals in selecting appropriate reconstructive strategies. Further research is needed to evaluate the outcomes and long-term effects of these surgical interventions to optimize patient care and improve functional outcomes for individuals affected by Noma.