Tratamento de microstomia após queimadura elétrica envolvendo a cavidade oral

Abstract

Injuries resulting from burns affecting the oral cavity have the potential to trigger severe physical and psychological consequences, leading to sequelae that directly impact the quality of life. Given the early stage of neurocognitive and behavioral development, children become particularly susceptible to experiencing significant adverse effects, rendering them a more vulnerable population to electrical burns. The inherent complexity of electrical burns requires specific surgical skills and the implementation of effective strategies for restoring the orofacial complex in a functional and aesthetic manner. Microstomia, a challenging complication resulting from the burn, has a direct impact on the development of basic functions such as chewing, speech, and oral hygiene. To achieve an appropriate outcome, it is imperative to meticulously assess the severity of the impairment and carefully choose the surgical method. The virtual planning feature is an important ally for preoperative planning, facilitating the creation of devices to prevent the recurrence of microstomia and synechiae. The aim of this study is to report the case of an 8-month-old male patient who fell victim to electrical burns in the oral cavity, initially treated conservatively due to the impossibility of determining the extent of necrosis. Local measures were implemented for infection prevention. However, the patient progressed to microstomia and synechiae, indicating the need for a surgical approach under general anesthesia as therapy. To optimize case management, an oral cavity device was crafted for postoperative use, aiming to prevent recurrence of perioral contracture and new adhesions between tissues. For the first fifteen days, the patient underwent daily follow-up for oral hygiene and assessment of device positioning. There was no recurrence of synechia, and adequate tissue release was achieved. Currently, at five months postoperatively, despite satisfactory mouth opening obtained during surgery, the lack of stimulation through physiotherapy resulted in recurrence in the condition. Parental awareness and the continuous implementation of preventive or supportive measures until the definitive therapeutic decision are crucial to mitigate the challenging complications arising from electrical burns.