Evaluation of oral-motor movements and facial mimic in patients with head and neck burns by a public service in Brazil

Abstract

OBJECTIVES:The purpose of this study was to analyze the characteristics of oral-motor movements and facial mimic in patients with head and neck burns.METHODS:An observational descriptive cross-sectional study was conducted with patients who suffered burns to the head and neck and who were referred to the Division of Orofacial Myology of a public hospital for assessment and rehabilitation. Only patients presenting deep partial-thickness and full-thickness burns to areas of the face and neck were included in the study. Patients underwent clinical assessment that involved an oral-motor evaluation, mandibular range of movement assessment, and facial mimic assessment. Patients were divided into two groups: G1 - patients with deep partial-thickness burns; G2 - patients with full-thickness burns.RESULTS:Our final study sample comprised 40 patients: G1 with 19 individuals and G2 with 21 individuals. The overall scores obtained in the clinical assessment of oral-motor organs indicated that patients with both second- and third-degree burns presented deficits related to posture, position and mobility of the oral-motor organs. Considering facial mimic, groups significantly differed when performing voluntary facial movements. Patients also presented limited maximal incisor opening. Deficits were greater for individuals in G2 in all assessments.CONCLUSION:Patients with head and neck burns present significant deficits related to posture, position and mobility of the oral myofunctional structures, including facial movements.

Reabilitação motora orofacial em queimaduras em cabeça e pescoço: uma revisão sistemática de literatura

“…According to the literature, burns are defined as lesions to organic tissues caused by traumas of different origins. These traumas can be thermal (exposure to flames, hot or cold liquids, and combustion), solid (by friction), electrical, chemical (sulfuric acid, caustic soda, nitric acid, and anhydrous ammonia), or by radiation (uranium, radium, plutonium, and the radiation produced by X-ray and radiotherapy devices), compromising the integrity of the skin and soft tissues (1)(2)(3) .…”

“…Epidemiological data show that burns account for over 300,000 deaths/year, and nearly 11 million people worldwide require burn-related medical assistance (1,4) . Statistics from the United States indicate that more than one million burns occur each year, with five thousand of these injuries being fatal, placing burns as the fourth leading cause of death from unintentional injuries (4,5) .…”

“…For this reason, the incidence rate of burns tends to vary considerably in the literature, and reports are usually limited to a single Burn Treatment Center (BTC) (1,4) . Burns are also a significant public health concern (1,4) , representing the second cause of death in children in Brazil (4) . The National Health Surveillance Agency (Anvisa) reports that there are approximately 300,000 new cases of child burns per year (6) .…”

“…Second-degree burns may be superficial or deep: the superficial ones affect the whole epidermis and a portion of the dermis, whereas the deep ones cause the destruction of practically the entire dermis. Third-degree burns, however, destroy all layers of the skin, and can reach subcutaneous and other deeper tissues such as muscles, tendons, bones, and the digestive and respiratory tracts (1,8) .…”

“…The contractile forces of the neck can also cause facial deformities and adversely affect the maturation of facial scars (14,15) . Burns in the head and neck region are prone to develop hypertrophic scars and contractures that may cause incomplete oral occlusion, impairments in articulation and feeding, difficulties in intubation, oromaxillofacial skeletal deformities, oral/dental hygiene difficulties, esthetic deformity, and facial expression and vocal changes (1,(16)(17)(18) . Third-degree burns in the orofacial region are described as complex and difficult to treat (16) .…”