Cheekbone fracture surgery and lower eyelid correction
Patient with facial injuries This is a 35-year-old patient from Jharkhand. He was hit by a speeding car which resulted in facial trauma before 2 years. The facial trauma resulted in facial bone fractures. He underwent emergency treatment for cheekbone fracture and lower eyelid correction in Jharkhand. The patient was not happy with the outcome of cheekbone fracture surgery. He complained of depressed cheekbone in the left side of the face. He requested for further cheekbone correction. Ectropion of eye He also complained of double vision in one eye (left) and lower eyelid drooping. His lower eyelid was sagging outwards thereby exposing the surface of the inner eyelid. There was noticeable difficulty in closing his left eye. He requested left lower eyelid surgery. The patient’s eye doctor had neglected the need for a second surgery. He advised him to use eye drops every day to prevent drying up of the left eye. Cheekbone fracture surgery in India Complete clinical and radiological evaluation done. Oral and Maxillofacial surgeon Dr. SM Balaji diagnosed malunited cheekbone fracture. He had hypoglobus and ectropion of the left eye. There was also a left orbital floor fracture which led to herniation of the orbital contents. Dr. SM Balaji the leading facial reconstructive surgeon in India planned to correct all his problems in one surgery. Fracture treatment along with ectropion correction Incision placed through the previous surgical scar. Layers dissected, thereby exposing the previously placed plates and screws. Removal of plates and screws done. The malunited cheekbone fracture was re-fractured. Re-fractured segment elevated and fixed using plates and screws. The floor of orbit reached. The herniated orbital floor contents released. Left orbital floor reconstruction surgery done using Titan Medpor implant. The implant was fixed using screws. Malpositioned lower eyelid released from the scar tissue. The ectropion of the left eye was also corrected using a medial canthal incision. Surgical outcome The check bone fracture corrected. The lower eyelid raised and reattached to its normal position. The orbital floor was also reconstructed successfully. The patient was happy with the outcome of the surgery.
Maxillary augmentation, nasal notch correction and alar web correction surgery
A brief introduction to Tessier’s facial cleft and their management Tessier’s facial clefts are of 14 types. They can extend from the hairline above the forehead to the mandible. These malformations can be debilitating for the patient and distressing for the family. It requires extensive surgical correction to rehabilitate these patients. Tessier’s facial clefts can also include malformations of the brain. A patient with Tessier’s facial cleft presents to our hospital This young man was born with Tessier’s facial cleft. He has already undergone innumerable surgeries elsewhere in the past. A doctor in his hometown referred him to our hospital for further management. Dr SM Balaji, facial reconstruction specialist, examined the patient and ordered radiographic studies. The patient needed maxillary augmentation, nasal notch correction and right alar web correction. He explained that rib grafts were mandatory for this surgery. The patient and his parents consented to the surgery. Surgical correction of labial and infraorbital defect with rib grafts Under general anesthesia, rib grafts were first harvested from the patient. A Valsalva maneuver demonstrated a patent thoracic cavity. The incision was then closed in layers with sutures. Attention was next directed to the patient’s labial defect. There was heavy scarring of the buccal vestibular mucosa from the previous surgeries. Incisions were made in the vestibular region. A costochondral graft was then shaped and placed in the anterior maxillary region. Rib grafts were then used to augment the remaining maxillary defects. The grafts were then fixed with screws. Sutures were then used to close the incisions. Attention was next turned to correction of the nostrils. Notching on the left nostril was then corrected followed by right alar web correction. The incisions were then closed with sutures. The patient recovered without event from general anesthesia. The patient and his parents expressed their complete satisfaction at the results. Surgery Video