It is the most common deformity one in 800 live birth. It presents with cleft lip with or with out cleft palate . Child needs immediate attention in terms of feeding and parental guidance. We involve entire family members in helping this child undergo surgery and further rehabilitation.

Protocol

  1. 4 to 6 months of age Cleft Lip ,Nose & Anterior Palate Repair.
  2. 9 to 12 Months of age Cleft Posterior Palate Repair.
  3. Speech Therapy.
  4. If speech is deformed then investigate with Nasoendoscopy, Videofluroscopy to decide about type of pharyngoplasty to improve speech.
  5. 6years at mix dentition Orthodontic dental alignment.
  6. 9 years Alveolar Bone grafting for bony gap in the alveolus.
  7. 16 t0 18 years Lip Nose Rhinoplasty and or Jaw Surgery.
  8. Jaw surgery such as Le Fort ,Bilat Sagital Split & Distraction Osteogenesis

I am a Smile Train Surgeon & Director of SMILE Train Project Shushrusha Hospital Dadar (w) for free surgery of Cleft Lip ,Palate & Deformities. For additional information www.smiletrain.org

Ear Reconstruction

Ear deformities are due to trauma , Infection,& congenital. Ideal time to operate on congenital ear deformities is 10 years. At 10 years of age size of ear is same as adult ear, and also get good quality costal cartilage for making cartilage frame work.

The type of surgical technique depends upon severity of deformity and availability of good quality surrounding skin. Ear is a three dimensional structure needs reconstruction in multiple stages.

Cranio Facial Surgery

The deformities involving skull and face are inter related these cases needs craniofacial approach along with Neurosurgeons. These cases are performed at Bombay Hospital and Medical research centre which has team of Neurosurgeon, Pediatric Neuro anesthetist, Craniofacial Plastic surgeon, Pediatrician. The deformities like Scaphocephaly, Brachycephaly, Plagiocephaly, Trigonocephaly , Miningoencephalocele , Orbital Hypertelorism & Rare Craniofacial Clefts are corrected in this hospital. We also deal with complex craniofacial trauma use A-O principles of fracture fixation.

Tissue Expansion

Tissue expansion technique is used in deformities where we need good quality of skin for reconstruction. The common indications are total nose reconstruction using expanded forehead flap, post burns scalp alopecia. The procedure involves insertion of silicon tissue expander under the skin at first stage. The expantion started by injecting saline through the external unidirectional port. After complete expantion and maturation at second stage the expander is removed and this expanded skin is used for reconstruction.

Burn Surgery

Post burns deformities involve ectropion of eye lids . facial scars eye brow econstruction, scalp alopecia, contractures of neck, elobow, & hand. Use of full thickness skin grafts, split thickness skin grafts , local flaps are used to correct the deformities.

Maxillo Facial Deformities

Temporo mandibular deformities such as TM Jt ankylosis, recurrant tm jt dislocations are treated with gap arthroplasty and reconstruction of new joint using costochondral graft and superficial temporal fascia.

Mandibular jaw deformities like mandibular prognathism or retrognathia can be corrected with necessary osteotomies. Maxillary osteotomies for maxillary retrusion , vertical excess can be planned and done using AO Techniques to achieve normal facial profile.