Extreme Microstomia in an 8-Month-Old Infant: Bilateral Commissuroplasty Using Rhomboid Buccal Mucosa Flaps

Objective: A case of extreme microstomia in an 8-month-old infant is presented. As a result of caustic acid ingestion at the age of a few weeks, the male infant developed progressive stricture of the perioral region preventing him from normal food intake. Methods: The patient was treated by bilateral commissurotomies and a total of 4 rhomboid flaps based in the buccal mucosa. Results: We were able to enlarge the mouth aperture and subsequently cover the created soft tissue defects, with good esthetic result. The patient learned to suck the feeding bottle and was able to demonstrate oral dynamics, including laughing and crying. Conclusion: We present our surgical technique, the postoperative functional and esthetic outcome, and a brief literature review. Only few publications deal with the same matter and none with a similar life-threatening case.