Noma neonatorum: an airway challenge in paediatrics

Abstract

Noma Neonatorum (NN) is a devastating gangrenous disease that leads to severe tissue destruction in the face. Patients who survive Noma suffer from its sequelae- facial disfigurement, trismus and speech impediments which often necessitate extensive reconstructive surgery. These facial anatomic distortions present a challenge to attending anaesthesiologist. Reports on anaesthetic techniques for Noma sequelae are limited. We describe the anaesthetic management of a 13-month-old child with sequelae of NN. The child underwent reconstructive surgery of nose and upper lip with orotracheal intubation. We discuss the characteristic features of NN and review techniques of intubation in difficult paediatric airway. To the best of our knowledge, this is the first report of anaesthetic management of NN sequelae in paediatric age group in India.