Successful cleft palate repair surgery with release of abnormal muscle attachment
Little girl from Cuttack presents for cleft palate surgery This is an 8-month old baby girl from Cuttack. She was born with an isolated cleft palate. Her parents were very disturbed over this. They were very worried about their first born baby girl’s condition. They searched the Internet for the cleft palate repair surgeon. This search led them to our hospital. Patient examined and surgery performed successfully Cleft palate repair specialist, Dr SM Balaji examined the patient. He then planned the surgery. He decided on cleft palate repair using the palatal pushback technique. Palatal flaps were first raised on the right and left sides. The abnormal attachments of the muscles of the palate were then detached. The muscles were next reattached in a normal position like a hammock. The nasal floor and oral parts were then closed in two layers. Positive suction test performed indicating good speech in the future Following surgery, positive suction test indicated successful palate repair surgery. The parents were very happy with the results. They expressed their gratitude before discharge from the hospital.
Bilateral Cleft Lip – Successful Primary Correction
This 3-month old baby boy was born with bilateral cleft lip and palate deformity. His parents who hail from Agartala were very troubled over his condition. Mother had difficulty feeding him and he became underweight. They decided to get the best treatment for their son. An extensive research for the best cleft lip and palate surgeon followed. This led them straight to our hospital for treatment. Cleft lip and palate deformity correction surgeon Dr SM Balaji examined the patient. He explained the treatment plan to the parents. This would be through Paul Black’s cleft repair technique. The parents were in complete agreement with the treatment plan. Following surgery, the baby’s appearance improved very much and he was able to feed well. He soon began gaining weight, much to the mother’s delight. The parents were very pleased with the results as there was minimal to no scar formation. Cleft palate correction will be at a later date.
Successful surgical correction of broad nose and long lower jaw
Patient presents for surgical correction of large nose and inability to close mouth This is a 25-year-old woman from Thrissur. She presented with complaints of a large nose and the inability to close her mouth. She also complained of speech difficulty, which affected her social life. She was also quite dissatisfied with her facial appearance. She researched the Internet for the jaw correction surgeon. Her research led her straight to our hospital. Treatment planning explained to the patient Dr SM Balaji examined the patient. He explained to her that she had a class III skeletal malocclusion and an anterior open bite. Surgery would include correction of both her complaints of malocclusion and broad nose. Successful outcome of surgical correction A bijaw surgery was first done to correct the long lower jaw and the anterior open bite. Attention was next turned to her nose. Lateral nasal cartilages were then removed. This was then followed by a Weir excision to correct her bulky nose. She was very pleased with the outcome of the surgery. She expressed her willingness to increase interaction with people after the surgery.
Successful mandibular reconstruction for a boy with Trabecular juvenile ossifying fibroma
This is a 10-year-old boy from Vadodara. He presented to our hospital with a large swelling on the right side of the face. This was first diagnosed as a ‘cyst’ elsewhere. He had already undergone enucleation of the cyst, but that surgery was unsuccessful. His father stated that the swelling returned with an increase in size and caused a great deal of pain. The parents were very worried about his future due to recurrence. His parents had searched the Internet for the facial deformity correction surgeon. Their search had led them straight to our hospital. Dr SM Balaji examined the patient. Radiographic investigations obtained at our hospital showed a mixed radiolucent and radiopaque lesion. This lesion was extending from the right ramus to the body of the mandible. It had a ground glass appearance. Histopathological examination confirmed it to be trabecular juvenile ossifying fibroma. Treatment planned for the patient included a right hemimandibulectomy. The parents were in complete agreement with the proposed treatment. Resection of fibroma was first done followed by a right hemimandibulectomy. The defect was then reconstructed using a mandibular reconstruction plate and costochondral grafts. This resulted in symmetry of the patient’s face. The parents were very happy with the outcome of the surgery.
Successful OKC resection and jaw reconstruction
This is a 32-year-old man from Palakkad. He complained of severe pain and swelling in his lower jaw. He also complained of difficulty opening his mouth and chewing food. He has been suffering from this condition for about four years now. He searched the Internet for the best jaw correction surgeon. His search led him straight to our hospital. Dr SM Balaji examined the patient. He recommended comprehensive testing for the patient. Clinical, radiological and histopathological examinations were then performed. This led to the diagnosis of an odontogenic keratocyst. There was complete obliteration of the mandibular body. Treatment plan included complete cyst resection and reconstruction of the lower jaw. This would be by utilizing costochondral grafts. The affected area of the lower jaw was then removed. This was along with the involved tooth to ensure zero recurrence. The costochondral rib grafts were then used to reconstruct the lower jaw. Titanium screws and plates helped achieve stable fixation of the grafts . The patient was very happy with the outcome of the surgery. There was no scar as all incisions were intraoral.
Deviated nose correction with cc graft
This is a 30-year-old male from Belagavi. He was involved in a road traffic accident. This resulted in a blocked nose with difficulty breathing. He had undergone a nose block clearance surgery elsewhere by open rhinoplasty. This resulted in him developing a deviated nose. There was also residual scars over the bridge of the nose and the columella. He was very dissatisfied with this and desired corrective surgery. He searched the Internet for the best nose deformity correction surgeon. This led him straight to our hospital. Dr SM Balaji examined the patient. The patient explained his problem. He said he had great difficulty breathing and that he wished for a more prominent nose. He agreed to the proposed treatment plan. Surgical correction would be through the use of a costochondral rib graft. The nasal deviation was first corrected by a right lateral osteotomy. The nasal bridge height was then increased. This was by using the graft harvested from the right inframammary region. A small piece of the tissue was next excised from the right supra-alar crease to lift up the right nostril. The results were immediate and the patient was very satisfied with the results. He expressed his gratitude before discharge from the hospital.
Improving facial profile by Masseter reduction
A 32-year-old male reported to our hospital with a complaint of square face. He was very unhappy with his facial appearance and requested for immediate correction of the same. Maxillofacial surgeon Dr. S.M.Balaji diagnosed it as bilateral masseter muscle hypertrophy. The Masseter muscle was partially excised bilaterally. The angle of the mandible on either side was also burred down. The lower jaw appeared more proportionate. He was pleased with the overall results and there was no scar formation as the entire procedure was done intra-orally.
Depressed nose correction by closed rhinoplasty
A 25-year-old girl reported to our hospital with complaints of depressed nose and asymmetrical upper lip. She was very unhappy with the shape of her nose and said that it affected her facial appearance. Maxillofacial Surgeon Dr. S.M.Balaji planned to correct her nose using cc graft. Rib cartilage graft was harvested from the 8th intercoastal rib. The nasal bridge was augmented with cc graft. The left side of the nose was elevated using the cc graft as a strut graft. The lip revision was also done using Modified Millard’s technique. Results were immediate and the patient was very pleased with her new looks. This dramatically improved her appearance and helped regain her confidence.
Successful surgical correction of diplopia and depressed zygoma
This is a 23-year-old male from Nagpur. He presented with complaints of diplopia in his right eye and a depression on the right side of the face. He has a history of RTA with emergent treatment of zygomaticomaxillary complex fracture. He was not happy with the outcome of the surgery. His diplopia had not been corrected by the surgery. He then searched the net for the best facial deformity correction surgeon. His search led him straight to our hospital. Dr SM Balaji examined the patient. The patient had diplopia of the right eye. The diplopia was present only at the extremities of gaze. A 3D CT scan revealed a depressed and malunited right zygoma. Maxillofacial Surgeon Dr SM Balaji planned the treatment. He planned to correct the depression by refracturing the zygoma. The right malunited zygoma was first exposed by a vestibular approach. The right zygoma was then refractured, elevated and fixed using Ti. plates and screws. The right orbital floor was then reconstructed with a Titan Medpor mesh. This was also fixed using titanium screws. He was very happy with the results of the surgery.
Successful correction of left side facial asymmetry due to RTA
This is a 33-year-old male patient from Siliguri. He met with an accident about three months ago. He underwent emergent treatment at a nearby local hospital. He realized that the accident had left him with a left sided double vision. He underwent three surgeries for his double vision, but this persisted. A depressed fracture of his left eyebrow and maxilla had left him with facial asymmetry. None of these issues were set right by the three surgeries. The oral surgeon who operated on him referred him to our hospital. He told the patient that all his problems would be set right. He presented for consultation. Dr SM Balaji examined him and recommended a 3D CT scan. This revealed a malunited zygomaticomaxillary complex fracture. The treatment plan was then explained to the patient. This would involve the use of a costochondral bone graft. A costochondral bone graft was first harvested from the sixth intercostal rib. Reconstruction of the lateral wall of orbit and orbital floor was then done with a Titan Medpor mesh. This corrected the diplopia and enophthalmos. The left zygomatic arch was then refractured and pushed inwards. Attention then turned to the left maxillary defect and depression in the left eyebrow. This was by using a costochondral bone graft, which was then fixed using titanium screws. The deviated left nasal bridge was then corrected using lateral osteotomy. The patient was very satisfied with the results of the surgery.