Microstomia Workup

  • Author: David Darrow, MD, DDS; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Jan 8, 2010
 

Laboratory Studies

No specific laboratory studies, imaging, or diagnostic procedures are required in the evaluation of microstomia. However, any systemic abnormalities that result from the underlying cause of the microstomia may affect the patient's ability to heal from the inciting event or to undergo anesthesia and surgery; thus, such systemic abnormalities should be sought. For example, patients with electrical burns should undergo an ECG because myocardial injuries, conduction abnormalities, or both are possible and must be promptly diagnosed. Computerized tomography or radiography of the chest may be useful in patients with scleroderma for determining the presence of pulmonary fibrosis. Endoscopic evaluation of the airway should be considered in patients with microstomia due to epidermolysis bullosa.

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Other Tests

ECG is appropriate in cases of electrical burns because myocardial injuries, conduction abnormalities, or both are possible and must be promptly diagnosed.

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Contributor Information and Disclosures
Author

David Darrow, MD, DDS  Associate Professor, Departments of Otolaryngology-Head and Neck Surgery and Pediatrics, Eastern Virginia Medical School

David Darrow, MD, DDS is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Bronchoesophagological Association, American Cleft Palate/Craniofacial Association, and American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Jaime Eaglin, MD  Housestaff Physician, Department of Otolaryngology-Head and Neck Surgery, Medical College of Virginia

Jaime Eaglin, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Jeffrey D Carron, MD, FAAP, FACS  Associate Professor of Otolaryngology, Department of Otolaryngology and Communicative Sciences, University of Mississippi School of Medicine; Pediatric Otolaryngologist, University of Mississippi Medical Center

Jeffrey D Carron, MD, FAAP, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society of Pediatric Otolaryngology, and Society for Ear, Nose and Throat Advances in Children

Disclosure: Nothing to disclose.

Specialty Editor Board

Hassan H Ramadan, MD, MSc  Professor and Vice-Chair, Department of Otolaryngology-Head and Neck Surgery, Professor, Department of Pediatrics, West Virginia University

Hassan H Ramadan, MD, MSc is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Rhinologic Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Gregory C Allen, MD  Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Gregory C Allen, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Laryngological Rhinological and Otological Society, American Medical Association, Christian Medical & Dental Society, and Colorado Medical Society

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position

References

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Child with Freeman-Sheldon syndrome.
Child with Freeman-Sheldon syndrome demonstrating limited vertical expansion.
Child with craniofacial anomalies and microstomia. A tracheotomy is in place for airway control because of micrognathia. Advancement osteotomies have been performed in an effort to lengthen the mandible.
Microstomia prevention apparatus (MPA).
Commissuroplasty, as performed by Converse (1959). (A) Skin excision designed to accommodate elongation of the commissure. (B) Skin excision performed and mucosal incisions diagrammed. (C) Mucosal flaps incised and mobilized. (D) Mucosal flaps sutured in place. (Reprinted from Converse JM and Wood-Smith D. Techniques for repair of defects of the lips and cheeks. In Converse JM, ed. Reconstructive Plastic Surgery, 2nd edition, volume 3. WB Saunders; Philadelphia:1977. pp.1574, with permission from Elsevier).
Commissuroplasty, as performed by Gillies and Millard (1957). (A) Triangular skin excision designed to accommodate elongation of the commissure. A flap of vermilion is raised from the lower lip. (B) Vestibular mucosa is advanced externally to reconstruct the vermilion of the lower lip. (C) The vermilion flap is rotated and sutured laterally to reconstruct commissure. (Reprinted from Converse JM and Wood-Smith D. Techniques for repair of defects of the lips and cheeks. In Converse JM, ed. Reconstructive Plastic Surgery, 2nd edition, volume 3. WB Saunders; Philadelphia:1977. pp.1575, with permission from Elsevier).
Schematic representation of orbicularis oris muscle-lengthening procedure.
Schematic representation of orbicularis oris muscle-lengthening procedure.
 
 
 
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