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Correction of Microstomia Reconstruction With the Use of Acellular Dermal Matrix for Buccal Reconstruction

Wood, Benjamin C., MD*; Mantilla-Rivas, Esperanza, MD*; Goldrich, Agnes; Boyajian, Michael K., BA; Oh, Albert K., MD*; Rogers, Gary F., MD, JD, MBA, MPH*; Boyajian, Michael J., MD*

Journal of Craniofacial Surgery: May 2019 - Volume 30 - Issue 3 - p 736–738
doi: 10.1097/SCS.0000000000005182
Original Articles

Correction of microstomia is challenging with a high rate of recurrence. We report the successful treatment of microstomia using acellular dermal matrix (ADM) as an adjunct for intraoral lining with >1 year of follow-up.

A 9-year-old international patient with severe immunodeficiency presented with severe microstomia because of recurrent oral infections. She had undergone 3 previous failed attempts to re-establish an adequate oral opening and was dependent on enteral nutrition via gastrostomy tube. She underwent release of the oral commissure scar contracture and orbicularis oris and the resultant mucosal defect was lined with ADM. A postoperative splint was used for 8 weeks. One-year follow-up demonstrated maintenance of the oral aperture with complete mucosalization of the ADM; the patient was able to resume oral diet and regular dental hygiene.

Mucosal reconstruction with ADM is a viable alternative to local flaps and in this case exhibited minimal soft tissue contraction.

*Division of Plastic Surgery, Children's National Health System, Washington, DC

College of Agriculture and Life Sciences, Cornell University, Ithaca, NY

Warren Alpert Medical School of Brown University, Providence, RI.

Address correspondence and reprint request to Gary F. Rogers, MD, JD, MBA, MPH, Chief, Division of Plastic Surgery, Children's National Medical Center, 111 Michigan Ave., N.W., Washington, D.C., 20010; E-mail:

Received 3 August, 2018

Accepted 4 November, 2018

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.