title: [Noma].
abstract: Noma is a necrotizing ulcerative stomatitis known since Antiquity. It occurs mostly in poor countries, the Sahel countries being the most affected. Each year, several hundred thousand cases are reported. Noma affects especially malnourished children who are less than 6 years old and rarely adults with acquired immunodeficiency (HIV, cancer). Ulcerative lesion is occurring rapidly due to the production of endotoxins by bacteria from oral commensal, telluric and animal origin. Necrotic debridement leads to huge defects: loss of soft tissue (skin, nerves, vessels, eye), bone (maxilla, mandible) and teeth. Death occurs rapidly in a few weeks in 80 % of the cases. In case of survival, the consequences are functional, aesthetic, psychological and social. The goal of the treatment in the acute phase is the patient's survival and the fight against limited mouth opening. The management of the phase of sequela is an anaesthetic, surgical and physiotherapy challenge. Its purpose is the social reintegration of the patient.
authors.affiliation: Service de stomatologie, chirurgie maxillo-faciale, chirurgie plastique esthétique et reconstructrice, chirurgie de la main, centre hospitalier universitaire de Dijon, boulevard Delattre-de-Tassigny, 21000 Dijon, France; Laboratoire EA 4268 4IS, université de Franche-Comte, place Saint-Jacques, 35000 Besançon, France. Electronic address: nzwetyenga@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Zwetyenga
authors.affiliation: Service de stomatologie, chirurgie maxillo-faciale, chirurgie plastique esthétique et reconstructrice, chirurgie de la main, centre hospitalier universitaire de Dijon, boulevard Delattre-de-Tassigny, 21000 Dijon, France.
authors.forename: L-A
authors.initials: LA
authors.lastname: See
authors.affiliation: Service de chirurgie plastique, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Szwebel
authors.affiliation: CHRU, 80054 Amiens cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Beuste
authors.affiliation: Département d'anesthésie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Aragou
authors.affiliation: Département d'anesthésie, centre hospitalier universitaire de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
authors.forename: C
authors.initials: C
authors.lastname: Oeuvrard
authors.affiliation: Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Martin
authors.affiliation: Calle Federico García Lorca, 7, 20014, San Sebastian, Espagne.
authors.forename: A
authors.initials: A
authors.lastname: Emparanza
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005843:Geography; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009625:Noma / Q000453:epidemiology / Q000266:history / Q000473:pathology / Q000628:therapy
keywords: Children; Enfants; Gangrenous; Gangrène; Malnutrition; Microbiome; Microbiome oral; Noma