American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review


A Thirty-Year Review of Oral Appliances Used to Manage Microstomia, 1972 to 2002

Dougherty, M. E., & Warden, G. D. (2003).
The Journal of Burn Care & Rehabilitation, 24(6), 418-431; discussion 410.

Indicators of Review Quality:

The review addresses a clearly focused question No
Criteria for inclusion of studies are provided No
Search strategy is described in sufficient detail for replication No
Included studies are assessed for study quality Yes
Quality assessments are reproducible No

Description: This is a review of articles pertaining to the use of oral-stretching devices for the management of microstomia due to facial burns. Although not directly related to speech and language treatment, the review provides information pertaining to oral motor devices that may be helpful to individuals with communication and eating difficulties as a result of burns. The findings of the review suggest that no device is ideal for every patient. However, "exercise, pressure, and massage are essential and must be included as well for optimal patient outcome" (p. 430).

Question(s) Addressed:

Question not specifically stated.

Population: Patients with microstomia

Intervention/Assessment: Various devices used to manage microstomia

Number of Studies Included: 37 devices examined

Years Included: 1972 - 2002

Findings:

Conclusions:

  • "Each appliance has advantages and disadvantages...[but] removable appliances may not produce good results because these devices rely on the patient's compliance" (p. 429).
  • "Early splinting decreases the need for surgical reconstruction and splinting should continue until the scar is mature" (p. 430).
  • "No orthosis will be ideal for every patient" (p. 429).
  • "Exercise, pressure, and massage are essential and must be included as well for optimal patient outcome" (p. 430).

Keywords: Craniofacial Disorders, Oral Motor

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Added to Compendium: November 2011

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