The Presence and Presentation of Microstomia in Burn Survivors: A Burn Model System Study

Microstomia, or small oral aperture, often results from facial burns. This condition appears as scars form within the oral tissue and at the oral commissures, narrowing the oral opening, and leading to mobility, speech, respiratory difficulties, emotional distress, and social interaction challenges. This study examines the presence of reported burn microstomia and its related clinical factors. Pediatric and adult data from a multicenter longitudinal database from 2003-2005 were analyzed to determine the frequency of microstomia at discharge. Summary statistics were used to describe clinical characteristics, demographics, and burn location in pediatric and adult burn survivors. Clinical and burn characteristics were then tested to determine if there was an association with the development of microstomia. Data revealed 4.7% (n = 10) of adult burn survivors (n=214) and 11% (n =10) of pediatric burn survivors (n=91) presented with microstomia at hospital discharge. Those with microstomia had significantly larger TBSA burns, higher rate of inhalation injury, more days on ventilation, and higher rate of adjacent contractures. No differences were found when considering age, sex, race, ethnicity, etiology of burn, or discharge location. Burn size and length of time requiring ventilation were predictive of microstomia. Knowledge of these risk factors suggests therapists should focus on early microstomia prevention, even during times of ventilation, especially in those with larger burn injuries. The high incidence of adjacent contractures demonstrates the impact of cutaneokinematic skin recruitment and suggests areas beyond the perioral should be considered when developing a treatment and prevention program for microstomia following a burn injury.