Noma surgery Article

Full Text via DOI: 10.1002/lary.27230 PMID: 30194753 Web of Science: 000454949300029
International Collaboration

Cited authors

  • Shaye, David A.; Winters, Ryan; Rabbels, Jens; Adentunji, Adenyiyi Seminyu; Magee, Aidan; Vo, Daniel


  • Objective Noma is a devastating and destructive disease of the face for which there is a dearth of information regarding surgical options. Herein, we describe the facial deformities and patient characteristics in a patient population affected by noma and the surgical approaches used in treatment. Methods Retrospective case series of a Doctors Without Borders (Medecins Sans Frontieres) intervention at Sokoto Children's Noma Hospital in northern Nigeria, the highest-volume noma hospital in the world. Results Twenty-two procedures were performed on 18 patients with noma, 44% of whom were children. The majority of patients (n = 10, 55.5%) were made aware of surgical care through a Doctors Without Borders outreach program. Patients' reasons for seeking care included functional (61.1%, n = 11), appearance (61.1%, n = 11), and social stigma (66.7%, n = 12). The majority (83.3%, n = 15) had lip involvement. Four patients (22.2%) underwent staged flap procedures including prelamination, flap delay, or pedicle division. The mean duration of surgical procedure was 87 minutes (range 5-306 minutes). The minor complication rate was 16%. There were no major complications or deaths. Conclusion Noma is a mutilating disease of the face that occurs in settings of extreme malnutrition. A total of 55.5% of noma patients were made aware of surgical care through outreach programs. The majority of noma patients seek care to improve function (61.1%) and appearance (61.1%), and to address social stigma (66.7%). A total of 83.3% of noma patients had lip involvement. Facial reconstructive surgeons must rely on principles of congenital, traumatic, and oncologic deformity repair while focusing on safe, reliable procedures for low-resource settings.

Publication date

  • 2019

Published in

International Standard Serial Number (ISSN)

  • 0023-852X

Start page

  • 96

End page

  • 99


  • 129


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