Noma and Necrotizing Fasciitis of the Face and Neck

Lauren E. Miller; David A. Shaye

doi:10.1055/s-0041-1722894

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2021; 37(04): 439-445
DOI: 10.1055/s-0041-1722894

Original Article

Noma and Necrotizing Fasciitis of the Face and Neck

Lauren E. Miller

¹Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts

,

David A. Shaye

¹Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts

²Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts

³Doctors without Borders, Noma Project, Sokoto, Nigeria

› Author Affiliations

Abstract

Necrotizing fasciitis (NF) is part of the class of necrotizing soft tissue infections characterized by rapid fascial spread and necrosis of the skin, subcutaneous tissue, and superficial fascia. If left untreated, NF can rapidly deteriorate into multiorgan shock and systemic failure. NF most commonly infects the trunk and lower extremities, although it can sometimes present in the head and neck region. This review provides an overview of NF as it relates specifically to the head and neck region, including its associated clinical features and options for treatment. Noma, a related but relatively unknown disease, is then described along with its relationship with severe poverty.

Keywords

noma - necrotizing fasciitis - reconstructive surgery

Full Text

References

References
1 Kaul R, McGeer A, Low DE. et al. Population-based surveillance for group A streptococcal necrotiziug fasciitis: Clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Am J Med 1997; 103 (01) 18-24
2 van Niekerk C, Khammissa RAG, Altini M, Lemmer J, Feller L. Noma and cervicofacial necrotizing fasciitis: clinicopathological differentiation and an illustrative case report of noma. AIDS Res Hum Retroviruses 2014; 30 (03) 213-216
3 García De Polavieja M, Fernández R, Martínez C, Prieto F, García L, Bravo D. Necrotizing soft tissue infections. Enferm Infecc Microbiol Clin 1996; 14 (01) 16-20
4 Fung V, Rajapakse Y, Longhi P. Periorbital necrotising fasciitis following cutaneous herpes zoster. J Plast Reconstr Aesthet Surg 2012; 65 (01) 106-109
5 Adewale AO, Olamide OT, Yussuf SA, Stephen IO. Cervicofacial necrotizing fasciitis in patients with no underlying medical conditions: a review of four cases seen in twelve months at a Nigerian tertiary hospital. Iran J Med Sci 2018; 43 (06) 653-658
6 Carter LM, Layton S. Cervicofacial infection of dental origin presenting to maxillofacial surgery units in the United Kingdom: a national audit. Br Dent J 2009; 206 (02) 73-78
7 Bhaskaran M, Manappallil R, Manuel R, Gopi J. Necrotizing fasciitis of the face and neck following a dental procedure. Saudi J Oral Sci 2019; 6 (02) 113
8 Williams SR, Carruth JA, Brightwell AP. Necrotizing fasciitis of the face without significant trauma. Clin Otolaryngol Allied Sci 1992; 17 (04) 344-350
9 Mathieu D, Neviere R, Teillon C, Chagnon JL, Lebleu N, Wattel F. Cervical necrotizing fasciitis: clinical manifestations and management. Clin Infect Dis 1995; 21 (01) 51-56
10 Schröder A, Gerin A, Firth GB, Hoffmann KS, Grieve A, Oetzmann von Sochaczewski C. A systematic review of necrotising fasciitis in children from its first description in 1930 to 2018. BMC Infect Dis 2019; 19 (01) 317
11 Shindo ML, Nalbone VP, Dougherty WR. Necrotizing fasciitis of the face. Laryngoscope 1997; 107 (08) 1071-1079
12 Arif N, Yousfi S, Vinnard C. Deaths from necrotizing fasciitis in the United States, 2003-2013. Epidemiol Infect 2016; 144 (06) 1338-1344
13 Manasia A, Madisi NY, Bassily-Marcus A, Oropello J, Kohli-Seth R. Ludwig's angina complicated by fatal cervicofascial and mediastinal necrotizing fasciitis. IDCases 2016; 4: 32-33
14 Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg 2014; 1: 36
15 Ferzli G, Sukato DC, Mourad M, Kadakia S, Gordin EA, Ducic Y. Aggressive necrotizing fasciitis of the head and neck resulting in massive defects. Ear Nose Throat J 2019; 98 (04) 197-200
16 Livingstone JP, Hasegawa IG, Murray P. Utilizing negative pressure wound therapy with instillation and dwell time for extensive necrotizing fasciitis of the lower extremity: a case report. Cureus 2018; 10 (10) e3483
17 Bağli BS, Durgut O. Hyperbaric oxygen therapy as adjuvant therapy in necrotizing fasciitis of the face: case report. Undersea Hyperb Med 2018; 45 (06) 695-699
18 Auluck A, Pai KM. Noma: life cycle of a devastating sore - case report and literature review. J Can Dent Assoc 2005; 71 (10) 757
19 Marck KW. A history of noma, the “Face of Poverty”. Plast Reconstr Surg 2003; 111 (05) 1702-1707
20 Adelsberger L. Medical observations in Auschwitz concentration camp. Lancet 1946; 1 (6392): 317-319
21 Enwonwu CO, Falkler Jr WA, Phillips RS. Noma (cancrum oris). Lancet 2006; 368 (9530): 147-156
22 Bourgeois DM, Leclercq MH. The World Health Organization initiative on noma. Oral Dis 1999; 5 (02) 172-174
23 Farley E, Oyemakinde MJ, Schuurmans J. et al. The prevalence of noma in northwest Nigeria. BMJ Glob Health 2020; 5 (04) e002141
24 Tempest MN. Cancrum oris. Br J Surg 1966; 53 (11) 949-969
25 Emslie RD. Cancrum oris. Dent Prog 1963; 13 (495) 22-30
26 Falkler Jr WA, Enwonwu CO, Idigbe EO. Isolation of Fusobacterium necrophorum from cancrum oris (noma). Am J Trop Med Hyg 1999; 60 (01) 150-156
27 Ogbureke KU, Ogbureke EI. NOMA: a preventable “scourge” of African children. Open Dent J 2010; 4 (01) 201-206
28 Phillips RS, Enwonwu COFW, Falkler WA. Pro- versus anti-inflammatory cytokine profile in African children with acute oro-facial noma (cancrum oris, noma). Eur Cytokine Netw 2005; 16 (01) 70-77
29 Lembo S, De Leonibus C, Francia MG, Lembo C, Ayala F. Cancrum oris in a boy with Down syndrome. J Am Acad Dermatol 2011; 64 (06) 1200-1202
30 Millogo M, Konsem T, Ouedraogo D, Ouoba K, Zwetyenga N. HIV and noma in Burkina Faso [in French]. Rev Stomatol Chir Maxillofac 2012; 113 (06) 433-436
31 Marck KW, De Bruijn HP, Schmid F, Meixner J, Van Wijhe M, Van Poppelen RHM. Noma: The Sokoto approach. Eur J Plast Surg 1998; 21 (06) 277-280
32 Bos KK, Marck RV. The surgical treatment of noma. Accessed January 8, 2021 at: https://www.ntvg.nl/artikelen/surgical-treatment-noma/volledig
33 Shaye D, Winters R, Rabbels J, Adentunji A, Magee A, Vo D. Noma surgery. Laryngoscope 2019; 129 (01) 96-99
34 Saleh DB, Fourie L, Mizen KD. Reconstruction of complex oro-facial defects using the myocutaneous sub-mental artery flap. J Craniomaxillofac Surg 2014; 42 (05) 668-673
35 Giessler GA, Schmidt AB. Noma: experiences with a microvascular approach under West African conditions. Plast Reconstr Surg 2003; 112 (04) 947-954 , discussion 955–956
36 Estlander JA. Eine methode aus der einen lippe substanzverluste der anderen zu ersetzen. Plast Reconstr Surg 1968; 42 (04) 360-365
37 Coupe MH, Johnson D, Seigne P, Hamlin B. Special article: airway management in reconstructive surgery for noma (cancrum oris). Anesth Analg 2013; 117 (01) 211-218
38 Srour ML, Marck K, Baratti-Mayer D. Noma: overview of a neglected disease and human rights violation. Am J Trop Med Hyg 2017; 96 (02) 268-274
39 Rickart AJ, Rodgers W, Mizen K. et al. Facing Africa: describing noma in Ethiopia. Am J Trop Med Hyg 2020; 103 (02) 613-618
40 Yunusa M, Obembe A. Prevalence of psychiatric morbidity and its associated factors among patients facially disfigured by cancrum oris in Nigeria a controlled study. Niger J Med 2012; 21 (03) 277-281
41 Inediz Productions; MSF. Restoring Dignity: A Journey with Noma Survivors. Accessed June 20, 2020 at: https://noma.msf.org/noma-documentary/
42 Farley E, Bala HM, Lenglet A. et al. ‘I treat it but I don’t know what this disease is': a qualitative study on noma (cancrum oris) and traditional healing in northwest Nigeria. Int Health 2020; 12 (01) 28-35
43 Ahlgren M, Funk T, Marimo C, Ndiaye C, Alfvén T. Management of noma: practice competence and knowledge among healthcare workers in a rural district of Zambia. Glob Health Action 2017; 10 (01) 1340253
44 Farley E, Lenglet A, Abubakar A. et al. Language and beliefs in relation to noma: a qualitative study, northwest Nigeria. PLoS Negl Trop Dis 2020; 14 (01) e0007972
45 Caulfield A, Alfvén T. Improving prevention, recognition and treatment of noma. Bull World Health Organ 2020; 98 (05) 365-366
46 Shaye DA, Rabbels J, Adetunji AS, Magee A, Vo D, Winters R. Evaluation of the noma disease burden within the noma belt. JAMA Facial Plast Surg 2018; 20 (04) 332-333