Unilateral Mandibular Distraction with Advancement Genioplasty
The patient is a 23-year-old female from Mallapuram in Kerala, India. She had been involved in a minor road traffic accident when she was a little girl.
Micrognathia – Obstructive Sleep Apnea – Lower Jaw Advancement
The patient is a 12-year-old female from Guntur in Andhra Pradesh, India. She was around two years old when she tripped on a step and landed quite heavily on her chin. Her parents immediately rushed her to a local doctor who had prescribed analgesics for the pain.
Dr SM Balaji leads brainstorming session at deans meet in Saveetha Dental College
The Saveetha Transdisciplinary Annual Research (STAR) Summit was initiated to encourage the growth of student research in dental
Pharyngoplasty and Palatoplasty Speech Improvement Surgery
Patient born with cleft lip and palate deformity The patient is a 19-year-old college student from Guwahati in Assam, India. He was born with a bilateral cleft lip and palate defect. His parents had been extensively counseled regarding the condition. They were educated about the need to follow the correct schedules for surgical repair. The patient had first undergone cleft lip surgery at 3 months of age. This had been followed by a cleft palate repair at 8 months of age. The two surgeries had been performed at a medical center in a city near his hometown. He had however never undergone a cleft alveolus repair, which is normally performed at 3-1/2 years of age. There was a good esthetic result from the surgery with minimal scarring of the upper lip. Plastic surgeons also perform this cosmetic surgery in many countries. Increasing difficulty with speech with the passage of time The patient has always had problems with clear word-formation since childhood. He has always had difficulty with the pronunciation of certain sounds. His parents felt that there was a nasal quality to his voice. It sounded like he was talking through his nose at times. The patient had faced a lot of difficulties during his school days. Teachers had constantly complained that they could not understand his speech. He had also been subjected to teasing by his peers. All these factors made him withdrawn and he had very few friends. Initial visit to a local hospital for surgical consultation His parents had been counseled by well wishers of the family to get this speech problem addressed. They had visited a local hospital where they were informed that the patient needed surgical repair of his palate. The mechanism of the velopharyngeal insufficiency was explained to them in detail. They understood that the communication between the oral cavity and nose due to VPI was causing air to escape into his nose during speech. Following this, they had made widespread enquiries regarding the best hospital to get this corrected. They were then referred to our hospital for surgical management of his condition. Our hospital is a premiere center for speech correction surgery in India. We are a referral hub for palatal defect surgery and jaw reconstruction in India. Our hospital is credited with many surgical innovations in cleft lip and palate rehabilitation. Velopharyngeal insufficiency and its influence on word formation during the speech When a patient has velopharyngeal incompetence/insufficiency, the soft palate does not contact the back of the throat. This is mandatory for the creation of certain sounds. Air exits through the oral cavity during the creation of certain sounds. This air escapes into the nasal cavity when there is velopharyngeal insufficiency. The nasal quality to the speech arises because of this escape of air into the nasal cavity. Initial presentation at our hospital for surgical correction of the palate Dr SM Balaji, palate repair surgeon and sphincter pharyngoplasty specialist, examined the patient. He noted the quality of speech and explained the causes to the patient and his parents. It was explained to them that the velum was not occluding and this was resulting in the nasal speech. The patient was then referred to a speech pathologist for assessment was carried out. He was diagnosed with velopharyngeal insufficiency (VPI). Treatment planning is done and explained to the patient in detail It was explained to the patient and his parents that the palate surgery also needed to be redone. The palatal repair would be followed by a sphincter pharyngoplasty. This would result in complete normalization of the patient’s speech. Both procedures would be performed in a single surgery. Successful surgical correction of the velopharyngeal insufficiency Under general anesthesia, a palatoplasty was first performed using Veau-Wardill Kilner’s technique. The levator palati muscle was joined in the middle. This resulted in a good roof of the mouth palatal repair for the patient. This was followed by the sphincter pharyngoplasty. Flaps were raised from the palatopharyngeus muscle. These were then attached to the posterior wall of the pharynx. The attachment was at the level of the adenoids in the form of a posterior pharyngeal flap. This resulted in complete correction of the velopharyngeal insufficiency. A small central opening or “port” was left in the middle for breathing. A suction test was performed at the end of the surgery, which demonstrated good movement of the soft palate. A positive suction test indicates that the patient would have normal speech after rehabilitation following surgery. Total satisfaction with the results of the surgery The patient and his parents were very happy with the outcome of the surgery. His parents stated that there was considerable improvement in the quality of his speech following surgery. They were extensively counseled regarding the need for speech therapy for the patient. Speech therapists play an integral role in the successful rehabilitation of these patients. The patient and his parents expressed a complete understanding of the instructions. His parents stated that this surgery would help the patient gain self-confidence and develop a more active social life. Surgery Video width=”560″ height=”315″ frameborder=”0″ allowfullscreen=”allowfullscreen”>
Hemifacial Microsomia Surgery – Facial Asymmetry Correction
The patient is a 23-year-old female from Hubli in Karnataka, India. She had developed right-sided facial asymmetry from a very young age in life
Cleft Rhinoplasty – Unilateral Cleft Lip and Palate
Patient born with unilateral cleft lip and palate deformity The patient is a 24-year-old female from Mannargudi in Tamil Nadu, India. She was born with a cleft lip and palate deformity on the left. Her unilateral cleft lip and palate deformity greatly distressed her parents. They were extensively counseled by the doctors soon after the birth of the child. They had referred the parents to a local dental surgeon. He had examined the patient and had referred them to a hospital in a nearby city for surgical correction. Many cleft patients have a split roof of the mouth. Her parents had presented at the hospital. As instructed by the surgeon, the patient had undergone cleft lip surgery at 3 months of age. This had been followed by cleft palate surgery at 8 months and cleft alveolus surgery at 7-1/2 years of age. She had satisfactory functional and cosmetic results from the surgery. Development of progressive nasal deformity with growth The patient began noticing the gradual development of a deformity of her nose with time. Her nasal tip was depressed and this too added to the compromise in her facial esthetics. There was also a sunken appearance to her left nostril. Her upper lip however was cosmetically acceptable. She became very self-conscious about her appearance and became withdrawn. Around two years ago, her worried parents took her to the same hospital for consultation. The surgeon had examined the patient. He then explained that she needed to undergo a closed rhinoplasty procedure or a nose job. Previous rhinoplasty correction with unsatisfactory cosmetic results The patient had subsequently undergone nasal deformity correction with the utilization of costochondral grafts. She was however dissatisfied with the results and remained withdrawn. Improper positioning of the graft had led to increased deviation to her nose. This had resulted in increased worsening of the esthetic appearance of her nose. Her parents made the decision to get this addressed and made extensive enquiries regarding the best treatment options available. They had subsequently been referred to our hospital for her secondary rhinoplasty correction. Our hospital is also a specialty center for revision rhinoplasty. A specialized cleft team consists of professionals from varied specialties. Facial plastic surgeons also perform this surgery in Europe and America. Initial presentation at our hospital for nasal deformity correction Dr SM Balaji, the cleft rhinoplasty surgeon, examined the patient and obtained imaging studies. Her nose was depressed on the left side with compromise in both esthetics and function. There was also an asymmetry to the left alar base region. She expressed her desire to have a well-defined and sharp nose. It was explained to her that an autologous costochondral cartilage graft would be used to augment her nose. The Z-plasty surgery for correction of her alar base region was also explained to her. She was in complete agreement with the treatment plan and consented to surgery. Surgical correction of her nasal deformity with closed rhinoplasty Under general anesthesia, an incision was placed over the old incision in the right inframammary region. Costochondral rib graft was harvested from the patient. Following this, a Valsalva maneuver was then performed to ensure that there was no perforation into the thoracic cavity. The incision was then closed in layers with sutures. A Z-plasty was then performed to correct the depressed and asymmetric left alar base. This was followed by an intercartilaginous incision to the right nostril with partial excision of the lateral nasal cartilage Dissection was then done up to the nasal dorsum and the nasal bridge was augmented using the costochondral graft. The closure was done intranasally using resorbable sutures. General anesthesia was then reversed without any complications. The patient expressed complete satisfaction with the results of the surgery The patient was very happy with the outcome of the surgery. She now had an elevated and sharp nose that was also symmetrical with a good profile. Her nasal function was also improved. She said that her breathing was unobstructed with free flow of air now. She expressed that her levels of self confidence have improved significantly after surgery. Her parents too expressed their thankfulness before final discharge from the hospital. Surgery Video width=”560″ height=”315″ frameborder=”0″ allowfullscreen=”allowfullscreen”>
Dr SM Balaji meets with the Hon’ble Health and Tourism Ministers of Seychelles
Dr SM Balaji meets His Excellency Jean Paul Adam, Hon’ble Health Minister of Seychelles and His Excellency Didier Dogley, Hon’ble Tourism Minister of Seychelles
Successful Correction of Unilateral Cleft Lip
[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”Baby boy presents with unilateral cleft lip” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]The patient is a 11 months old baby boy from Jammu who was brought to our hospital seeking treatment for cleft lip and palate. A pre-natal diagnostic scan (Ultrasound of abdomen) had been done at the end of the first trimester in his hometown. It was then that the deformity was discovered and the parents were informed that their baby would be born with a cleft lip.[/vc_column_text][vu_heading style=”2″ heading=”Search for renowned cleft lip and palate repair center” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text] The parents were aware that their child would be born with this deformity. They therefore educated themselves about this condition. However, they were not very keen on getting the surgery done for their baby until he was about 10 months of age. They had also made widespread inquiries about the best hospital for cleft lip repair. Their inquiries led them to Balaji Dental and Craniofacial Hospital, which is a premier center for cleft lip and palate repair in India. The parents got in touch with our hospital when the baby was about 10 months of age. Detailed explanation was given regarding the treatment. Books authored by Dr SM Balaji providing comprehensive information about cleft lip and palate deformity and repair were also mailed to the parents. [/vc_column_text][vu_heading style=”2″ heading=”Initial presentation at our hospital for consultation and treatment planning” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Parents brought the child to our hospital at 11 months of age. Dr SM Balaji, Cleft Repair Specialist, examined the baby. He advised the parents regarding the need for lip repair surgery.[/vc_column_text][vc_row_inner equal_height=”” animation_delay=”” disable=”” id=”” class=””][vc_column_inner vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6724″ img_size=”full” add_caption=”yes”][/vc_column_inner][vc_column_inner vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6725″ img_size=”full” add_caption=”yes”][/vc_column_inner][vc_column_inner vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6726″ img_size=”full” add_caption=”yes”][/vc_column_inner][/vc_row_inner][vc_row_inner equal_height=”” animation_delay=”” disable=”” id=”” class=””][vc_column_inner vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”Successful rehabilitation following cleft lip surgery performed at our hospital” subheading=”” alignment=”left” custom_colors=”” class=””][/vc_column_inner][/vc_row_inner][vc_column_text] The patient underwent cleft lip repair surgery using the modified Millard’s technique. Suture removal was done after a period of seven days. Surgery was a resounding success and the baby’s appearance was greatly improved. His parents were overjoyed that the defect had been corrected with no visible scar formation. He looked like every other infant, gurgling and smiling spontaneously. The patient will undergo cleft palate surgery after a period of one or two months followed by alveolar cleft defect reconstruction at 3 and a half years of age. Parents expressed understanding of the same and expressed complete satisfaction at the time of discharge from the hospital. [/vc_column_text][vc_row_inner equal_height=”” animation_delay=”” disable=”” id=”” class=””][vc_column_inner vertical_align=”top” animation_delay=””][vc_single_image image=”6729″ img_size=”full”][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][/vc_section]
Professor Mark Boyd of University of Liverpool visits Balaji Dental and Craniofacial Hospital
Professor Mark Boyd of University of Liverpool visits Balaji Dental and Craniofacial Hospital
Neurofibroma – Fibrous Dysplasia Debulking Surgery
Patient diagnosed with fibrous dysplasia through genetic testing The patient is a 26-year-old man from New Delhi in India. He had been fine up until age 12 when he started developing right sided facial asymmetry. This had progressively gotten worse with gross deformity of the face. His parents had taken him to a leading facial plastic surgeon. Extensive testing had been performed on the patient. Genetic testing had been ordered with results positive for fibrous dysplasia with associated neurofibroma. Implications of the diagnosis had been explained to his parents in detail. It was explained that the only treatment was surgical management. Symptomatology and implications of fibrous dysplasia Fibrous dysplasia is a rare genetic disorder. It is abnormal growth of fibrous tissue that replaces normal bone tissue. This results in asymmetrical enlargement of the affected region, which leads to gross deformity. This condition needs facial plastic surgery for reestablishment of esthetics. There can be spontaneous remission of the condition. Fibrous dysplasia of the face leads to gross disfigurement. Surgical intervention is the only available treatment for management of fibrous dysplasia. Constant medical surveillance is advised in order to ensure that it does not affect any vital functions. Patient undergoes surgical intervention of his condition The patient has undergone two surgeries thus far for treatment of his condition. Both surgeries had been performed in New Delhi. Unfortunately, the results had been catastrophic for the patient. It had led to a dramatic decrease in the quality of his life. Incisions had been poorly designed in the first surgery. This had lead to unsightly scar formation. Excess fibrous tissue had been poorly contoured leading to worsening of his facial asymmetry. The patient had undergone a second surgery a few years later, which did not lead to any significant improvement. The patient has been depressed for a few years now over his condition. Seeing this, his parents had made enquiries about the best facial cosmetic surgeon in India. They had finally decided to come to our hospital for surgical management of his condition. Board certified plastic surgeons also perform this surgery in the European countries. Initial examination at our hospital along with treatment planning Dr SM Balaji, facial deformity surgeon, examined the patient and ordered for radiological studies including a 3D CT scan. This revealed overgrowth of fibrous tissue that had replaced bone on the right side of the facial skeleton. The patient had extreme facial asymmetry because of this. This was diagnosed as neurofibroma with fibrous dysplasia. The surgical procedure was explained to the patient and his parents in detail. They were in agreement with the treatment plan and consented to undergo surgery for facial asymmetry correction. Successful surgical removal of excess tissue for improving esthetics The patient was administered anesthesia through bronchoscopic intubation. A nasolabial incision was then made to expose the fibrous tissue. Excess tissue was removed using a mallet and burr through the stamp cut technique. Once adequate reduction had been obtained, the incision was closed with sutures. Attention was next turned to the right lower border of the mandible. An incision was made through a preexisting scar from a previous surgery. The lower border of the mandible was trimmed until it was symmetrical with the left side of the mandible. The incision was closed in layers once adequate reduction had been obtained. The patient and his parents were very happy with the results of the surgery. They stated that the patient was very happy with the facial form after surgery. They expressed their total satisfaction before final discharge from the hospital. Surgery Video width=”560″ height=”315″ frameborder=”0″ allowfullscreen=”allowfullscreen”>
