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.