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Journal Article > Research

Prospective outcomes of noma facial reconstructive surgery in Sokoto, Nigeria

Amirtharajah M, Olaleye M, Oluyide B, Lenglet A, Ariti C, Farley E, Winters R, Taiwo AO, Shaye DA
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Abstract

BACKGROUND

Noma is a gangrenous infection of the face that results in severe facial deformity, occurring primarily in malnourished and impoverished populations.


OBJECTIVE

To assess clinician- and patient-reported outcomes (PROs) before and after reconstructive surgery for patients with noma in northwest Nigeria.


METHODS

Objective outcomes were recorded using the noma-specific NOITULP (nose, outer cheek, inner cheek, trismus, upper/lower lip, particularities) classification system. PROs were recorded using a locally developed tool. Postsurgical changes were assessed by Wilcoxon signed-rank testing. Linear regression was used to look for associated risk factors. The inter-rater reliability (IRR) of the NOITULP score was assessed using the weighted kappa statistic.


RESULTS

Forty-nine patients (median age 25 years, 71% male) underwent local/regional flap reconstruction and/or trismus release. Twelve complications were reported. Univariate analysis showed a 3.20 change in PRO score (95% confidence interval 0.59 to 5.81, p = 0.018) per kilogram the patient underwent at time of surgery. The NOITULP score improved from a presurgery median of 3.5 to 2.3 (p < 0.0001), however, the IRR was poor (kappa = 0.0894, p < 0.0001). The PRO score also improved from a median of 7.0 to 12.0 (p < 0.0001).


CONCLUSIONS

Facial reconstructive surgery improves the NOITULP score and PROs in patients with noma in northwest Nigeria.

Countries
Nigeria
Subject Area
surgery & trauma carenoma
Collections
Noma
DOI
10.1089/fpsam.2023.0079
Published Date
26-Jul-2024
PubMed ID
38502845
Languages
English
Journal
Facial Plastic Surgery & Aesthetic Medicine
Volume / Issue / Pages
Volume 26, Issue 4, Pages 488-496
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