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Find a Paediatric Faciomaxillary Surgery
About the Department
The Cleft & Craniofacial Centre is located on the 3rd and 4th floor of the administrative building. It’s a comprehensive facility for taking care of children born with cleft lip and palate and other craniofacial deformities.
This is a state of the art facility with more than 10 specialities integrated to look after these children and reassure parents even before birth when a deformity is diagnosed till the child completes his or her growth.
Our Team of Experts
Our specialists include plastic surgeon, maxillofacial surgeon, ENT surgeon, orthodontist, paediatric dentist, speech pathologist, audiologist, nutritionist, patient facilitators and administrators.
Our patient and their family have access to all the specialists under one roof keeping the hospital visits to minimum.
Operations are carried out at the top of the line surgical suites at this JCIA accredited hospital which puts the facility at par with the best operating facilities across the world.
The surgical team takes great pride in getting the best outcome possible while doing their best to minimize adverse outcomes and complications.
The team members have been trained from capable centres across the globe and presently are sought after as resource person for several workshops, conferences and other knowledge sharing platforms. They have several research projects and publications to their credit.
Out Patient Clinic Timings
Monday & Thursday – 9 am to 4 pm
Saturday – 9 am to 1 pm
Clinical Services Offered
Craniofacial Anomalies
The Orofacial Cleft
An orofacial cleft involves the lip, the tooth bearing part of the upper jaw and the hard and soft part of the palate. It affects the nose, the ear and the midface. It also affects the person’s appearance, speech, swallowing, and hearing and causes intense physical and psychological suffering for the child and the family.
How does this happen?
We know that the orofacial cleft happens due to failure of fusion of parts of the embryo between the 4th and 12th week of intrauterine life. Often the damage is already done even before the mother realises, she is pregnant. However, what we do not know is to tell for sure how it happens; leave alone predict it or reliably prevent it, though there are several suspect genetic and environmental factors. Our best bet yet seems to be to treat the baby once it’s born since all the deformities are eminently correctable.
Secondary Deformities Following Primary Cleft Lip and Palate Repair
Unfortunately, in India like in many other parts of the developing world the quality of care varies widely. Several children have their lips and palates repaired and are never followed up. Even these operations are sometimes done inexpertly by surgeons who either have no interest in doing this delicate surgery or just do not have the necessary expertise. Because of this, we get patients from all over the country that had primary lip and palate repair and little else at other centres. So, we went one step ahead and developed a unique protocol to suit our situation to deal with these deformities with an integrated multi-disciplinary approach.
Any child having speech problem in spite of cleft palate repair and speech therapy may need another surgery to improve the speech and reduce the nasality.
Rare Craniofacial Clefts
These are clefts of the face and facial bones resulting in major deformities of the face. Some of these defects may involve the eyelids and the child may not be able to cover the eyes completely resulting in loss of vision. Therefore, it is very essential to reconstruct these deformities soon after birth to preserve the vision.
Non-Cleft Craniofacial Anomalies
Craniosynostosis
Due to arrest of growth in certain parts of the skull, it gets deformed leading to various shape and size of the head. It can either put pressure on the orbit leading to protrusion of eyeballs and/ or increase the pressure on the brain compromising the growth of the brain. Some of these children will have delayed development of brain by birth. The craniosynostosis release should be done ideally by the age of 9 – 12 months. These surgeries are done either to improve the appearance or relieve the pressure on the brain or both.
Malpositioned Orbits
The orbit is the bone surrounding the eyeball. Abnormal growth of the skull can displace the orbits either outwardly with more space between the two eyes or rarely vice versa. The correction of malpositioned orbits needs major craniofacial surgery and often more than one surgery.
Facial Asymmetry
Facial asymmetry, a noticeable difference in features from one side of the face to the other happens due to less growth of bones (especially lower jaw), muscles and other soft tissue. Often this is associated with ear deformities, malposition of orbits and facial nerve paralysis. The treatment is planned according to the severity of the deformities. However, the latest technique of distraction osteogenesis has shown good results for these deformities during growth.
Ear Deformities
Various ear deformities are associated with craniofacial anomalies. The extent can vary from slightly smaller size to total absent ear. When one ear is deformed, most often hearing is near-normal. However, hearing screen should be done in all children with ear deformities. Children with bilateral involvement may need hearing aids. Ear reconstruction is usually done at the age of 8-10 years depending on the growth of the child. Minor deformities of the ear can be corrected during early childhood.
Facial Bone Deformities
Abnormal jaw and facial development can be genetic or acquired due to disease or injury. This results in facial deformities, unattractive jaw or teeth protrusion, difficulty in chewing, speech, and jaw function. “Orthognathic” means “straight jaws”, and orthognathic surgery corrects the jaws and facial deformities. Distraction Osteogenesis is another latest technique to correct these deformities during the growing phase. Most of these patients will need pre-operative and post-operative orthodontic treatment.
Temporomandibular Joint Ankylosis
Fusion of lower jaw joint following unnoticed trauma or infection in early childhood leads to this problem. This is commonly found in developing countries and the effect is disastrous. Child cannot open the mouth and the facial bones do not grow properly. These children will need multiple surgeries, first to open the mouth to be able to eat and speak properly and later to correct the facial deformities.
Tumours, Malformations and Facial Fractures
Advancements in craniofacial surgery now permit the surgeon to repair facial fractures with the least possible scarring. The best time to correct facial bone fractures is within the first few days of the injury. Old fractures, which are misaligned, can be improved by craniofacial reconstruction using advanced 3D technology. Tumours and vascular malformation of the face can also be addressed in a similar way.
