NOMA - A REVIEW

Cancrum oris or noma is a condition not well known in western Europe a nd North America. It is, however, a relatively common cause of mortali ty and disability in children of undeveloped areas of Africa, Asia, an d South America. This paper describes the experience at Galmi Hospital , in the sub-Saharan region of South Africa in the Niger Republic, wit h 50 operative patients out of a group of 300 who were referred. An ex tensive review of the literature is presented describing the epidemiol ogical impact of the disease, the characteristics of the lesions, the pathogenesis, symptoms, sequelae, differential diagnosis, and preopera tive preparation. Additionally, we review approaches to anesthesia, me thods of reconstruction, and the most common causes of complications a nd mortality. Numerous photographs illustrating the devastating conseq uences of this problem are presented.