Management of firecracker induced oropharyngeal burns: A case report

Abstract

Burn injuries as a result of inhalation or ingestion have been reported to cause a number of long-term complications including oral contracture. Circumoral contracture may result in microstomia and subsequently manifest as difficulties with communication, swallowing, intubation, oral and dental hygiene. This case study describes a young woman that presented with severe burns of the oropharynx following insertion of a Roman Candle firecracker into her mouth, in an attempted suicide. A multidisciplinary team approach was utilised to facilitate the patient's recovery with considerable involvement of the psychiatrist, dietician and speech pathologist. Meticulous oral hygiene was imperative in facilitating wound healing although minimal pain relief was required. In view of the depth and extent of burn injury, the patient was considered to be at high risk of developing oral contractures. Long-term goals of contracture management were to: (1) prevent the development of oral contractures, including microstomia and velopharyngeal insufficiency (VPI), and (2) eliminate the need for reconstructive surgery. Intervention consisted of a rigorous splinting and exercise regime to preclude microstomia development. At 6 months post-injury, the patient's outcomes continue to be positive, with no loss in range of movement to the lips, buccal mucosa and soft palate. Other focuses of intervention discussed include the management of oral dysphagia, odynophagia, dysphonia and hypogeusia.

Keywords:

• Oropharyngeal burns
• microstomia
• contracture
• intervention