J Korean Assoc Maxillofac Plast Reconstr Surg.  2008 Jul;30(4):380-385.

Correction of microstomia by bilateral commissuroplasty using "over and out" buccal mucosa flaps: report of a case

• Ryu SY
• Kim HS
• Park HJ

Abstract

Microstomia can be occured as a result of direct injury to tissues such as chemical, thermal and electrical burns, and animal bites. It also may be secondary to contracture of burned perioral skin, or may result from scarring after reconstructive lip surgery. Narrowing of the oral aperture is not only disfiguring, but also limiting the oral access needed for introduction of food, insertion of dentures, oral hygiene, and dental treatment. Limited mouth opening may also interfere with mastication and speech. Few reports exist regarding correction of microstomia and reconstruction of the corners of the mouth. A 16-year-old girl with a bilateral cleft lip and palate presented with the limited mouth opening (approximately 20 mm), the esthetic problem due to the small lip, and the cleft lip-nasal deformity. The microstomia was corrected by bilateral commissuroplasty using "over and out" buccal mucosa flaps proposed by Converse. The intercommissure distance was increased from the preoperative 40 mm to the postoperative 60 mm. The one-year postoperative intercommissure distance was 54 mm, because the 6 mm relapse was occured. The bilateral commissuroplasty using "over and out" buccal mucosa flap could increase the width and general size of the oral aperture and improve the lip appearance.

Keyword

Microstomia; Cleft lip and palate; Commissuroplasty; Over and out buccal mucosa flaps

MeSH Terms

Adolescent
Animals
Bites and Stings
Burns
Cicatrix
Cleft Lip
Congenital Abnormalities
Contracture
Dentures
Humans
Lip
Mastication
Microstomia
Mouth
Mouth Mucosa
Oral Hygiene
Palate
Recurrence
Skin