This 5-year-old girl from Itarsi was born with a mouth that was very wide on the right side. The medical term for this condition is macrostomia. Her macrostomia and hemifacial microsomia resulted in underdevelopment of her right face. There may be absence of external ear in this condition. Ear tags may be present. The ear tags may contain cartilaginous tissue. If so, they need to be first dissected, repaired and sutured back.
This child will need several surgeries later for reconstruction of the lower jaw. Macrostomia correction is first done and the ear tags removal is then done. She needs complete follow up of growth of mandible on the right side. She also had a tongue tie and ear tags with an extra lobe of the right ear. The tongue tie was causing abnormal speech patterns in the child. Her parents had searched far and wide for the best facial deformity surgeon to correct this. Their search had been futile for many years. It was only around six months ago that they met the parents of a similar child. Surgery performed for that child at our hospital had resulted in perfect correction. This led the parents of this little girl straight to our hospital.
Dr SM Balaji examined this little girl and ordered diagnostic studies. He explained the proposed surgical plan to her parents. They were in complete agreement with his treatment plan. This was the first stage of surgical correction for this little girl.
Under general anesthesia, the tongue tie was first addressed. The lingual frenum was then dissected free to enable full extension of the tongue. This would enable normal speech for the child. Attention was next turned to the macrostomia correction. The vermillion border on the right side was first dissected. The excess tissue was then removed. The vermillion border was then sutured to ensure symmetry of the lips.
Attention was then directed to the ear tags and extra ear lobe on the right. The ear tags were first dissected free and excised. The extra ear lobe was also addressed in similar fashion with good esthetic results. Suturing of all incisions completed the surgical procedure.
The patient’s parents expressed their complete satisfaction with the results before discharge.
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