Leprosy
Mailing List – November 6th, 2010
Ref.: Case
presentation (Perforation of the palate in leprosy)
From:
Theuvenet, J. Willem, Apeldoorn, The Netherlands
Dear
Dr.
Krishna
Bdr Tamang, Namasté!
Thank
you for sharing the problems of this patient (LML Nov. 5th,
2010). The perforation in his palate is the result of the chronic
inflammation of the mucosa of his nose as often seen in
multibacillary leprosy. Is
he not also having an erosion of his nasal septum?
The
problems in eating and drinking can be partially elevated by a
dentist/orthodontist who can make a removable palatal inlay for him
that will cover his palate and should facilitate his eating and
drinking. It will take a
while after finishing his MDT and before the nasal inflammation has
completely subsided. Only
then it may be safe to make an attempt to reconstruct the palatal
defect. Depending on the
condition of his palate and the size of the defect the solution may be
in a reconstruction according to Langenbeck or coverage with a dorsal
tongue flap.
As
you now have an excellent hospital for reconstructive surgery in the
Kathmandu valley, with plastic surgeons skilled in cleft lip and
palate repair, I would suggest that your patient seeks their advice in
due time!
Wih
kind regards,
Dr.
Willem J.Theuvenet,
Plastic
Surgeon
