Head, Face & Neck — Congenital

Conception of a child is said to be one of the most overwhelming experience for a mother. Unfortunately, this wasn’t the case for NJ and her family. She was devastated on knowing that her child born with a massive deformity of the face.
Her plight of having given birth to a deformed child could not be overstated. After being turned down by many cleft centres, she had lost hope of any form of treatment till she visited us.
Here, her daughter, Z was diagnosed with a severe form of right sided Tessier cleft, 2-12 – unilateral hypertelorism, fronto-encephalocele, and cleft palate and microphthalmia (Figure 1, 2.1).
A staged treatment plan was laid down. At 1 year of age bony correction of the orbits and the calvarium (Skull Bone) was done (Fig . 2.2 –2.4).
At 21/2 year of age the cleft palate and lip was repaired.
At 4 years reconstruction of the upper and lower eyelids and the medial canthus was done.
The scrumptious improvement which Z’s family has witnessed over these years have reinstated their faith and have lightened their hopes for a better future for Z.
Since this patient came from an indigent background, Saifee Hospital Trust has been sponsoring her treatment and have promised to continue to do so in the subsequent treatment which she may require.

Head, Face & Neck - Trauma

Riding over the J J flyover this 18 year old college student met with an unprecedented accident. His bike slipped off the road and he banged head-on to the roadside barrier with colossal force.
His face had torn apart and his facialbones were shattered (Fig 1).
He was brought to the emergency department of Saifee Hospital .
The survival rate of patients with such massive injuries is quite low, mainly due to the obstruction of the upper airway, blood loss, injuries to the brain and other internal organs.
In this case the emergency medical officer performed a tracheostomy and established an IV immediately on arrival which proved to be a life saver for this boy.
During the primary surgery, the facial bones were aligned and the soft tissues were sutured back.
However due to the magnitude of injury some portions of the soft tissue gradually necrosed leaving behind a deformity in the naso-labial region.
And thus the reconstructive ladder began. Composite flaps were used to reconstruct the nose and upper lip & palate.
Inspite of multiple surgeries, disfigurement still exists.
This case was one of those avoidable incidents only if the patient had worn a helmet and driven responsibly.
We witness such incidents routinely at our emergency facilities. Inspite of relentless efforts by local authorities and the doctor fraternity to spread awareness about road safety, such cases only seem to be on a rise.

Head, Face & Neck - Reconstruction

Reconstruction of defects following  cancer surgery remains a significant part of Plastic Surgery

Local or distant flaps are used to reconstruct the  defects created after cancer excision.

Head, Face & Neck - Malignancy

India is the capital for oral cancer. Statistics suggest that 5 people die of oral cancer every hour in India.
Unchecked tobacco use remains the main culprit in these cases.
This 57 year old male had developed oral squamous cell carcinoma of the lower alveolus and cheek.
Radical Surgery was performed to remove a part of the lower jaw and some portion of the cheek which was involved with the cancer was also removed.
This created a huge deformity of the lower face.
The fibula bone was harvested and transferred to reconstruct the excised portion of the lower face to restore form and function.
Early detection & treatment of oral cancers is crucial for patient’s survival.
Dr Yusuf Mistry has actively participates in anti-tobacco campaigns to spread awareness against tobacco use.

Upper Limb—Congenital

Hand is an extension of the mind—Rabindranath Tagore

Therefore it has to nimble and dexterous as the mind.

Syndactyly is one of those congenital anomalies (fusion of the fingers).

In Apert’s Syndrome the hand becomes a spade like affecting the day to day activities of the individual.

Fortunately, surgical treatment results in gratifying improvements.

This child was operated in stages to release each finger at a time.

Inspite of her deformity, this child appeared to be a mehendi enthusiast as she would always show up with mehendi on her hands at follow ups.