Doctors at Amrita Hospital in Faridabad successfully operated on a four-year-old boy born with Median Facial Cleft Syndrome, a very rare facial deformity that bisects (divides) the face vertically through the midline due to improper fusion of bone and tissue. The 18-hour marathon surgery restored the young child’s appearance, giving him a new lease on life. The boy, whose father works in a multinational IT firm in Gurugram, had a midline gap in his face that extended from the skin and hard tissue up to the skull base and brain. The gap increased the distance between his eyes (Orbital Hypertelorism), according to a press release by the hospital.
A cleft lip, palate, and nose were also present, as was a Basal Encephalocele (a pouch of brain tissue herniating from the skull base into the nasal cavity). These anomalies caused issues with binocular vision, speech, and feeding, as well as psychosocial and aesthetic challenges. The parents were homeschooling the child because they were afraid he would be teased at school or that other children would be scared seeing his face.
“We have the most comprehensive department of plastic and reconstructive surgery, which can cater to all Craniofacial anomalies,” said Dr. Mohit Sharma, Head, of the Department of Plastic and Reconstructive Surgery. “We have state-of-the-art facilities for performing lengthy, complicated surgeries. A team of ten doctors performed the surgery,” adding that the surgeons practised both virtually and physically by performing mock surgeries on 3D printed models. The mock and virtual surgeries allowed them to visualise the extent of corrective measures that would be implemented,” he added further, as per the press release.
Dr Anil Murarka, Senior Consultant, Department of Plastic and Reconstructive Surgery, and Dr Arun Kumar Sharma, Consultant (Cranio-Maxillofacial Division), led the complex surgery, it said.
Following surgery, the patient was transferred to a paediatric intensive care unit on ventilator support. His vitals were stable for the first 2-3 days, and he was breathing well on his own. He wasn’t completely arousable, though. Post-operative CT scans revealed a basal infarct (tissue death caused by a lack of blood supply) in the brain. The doctors also noticed that the right side of the body had slight hemiparesis (inability to move).
“The long surgery had taken its toll on the delicate brain of the child,” said Dr Maninder Singh Dhaliwal, Senior Consultant, and Dr Veena Raghunathan, Senior Consultant of the Department Paediatric Critical Care, Emergency & Respiratory Medicine. “Our paediatric intensive care team decided to tracheostomise the patient (create an opening into the trachea or windpipe from outside the neck to help air reach the lungs). This aided the doctors in removing the boy from the ventilator. We were now waiting for his neurological recovery. The patient was hospitalised for three weeks before being discharged. He is now doing well after a month and a half,” the doctors said.
“The boy is walking on his own and using both hands well.” It would probably take 3-4 weeks for him to return to his usual playful self. We now expect him to return to school and resume his daily social life with pride and confidence,” the doctors said further.
“My son’s condition is improving every day, and we are all so excited to see him recover and go to school like any other child his age,” said the boy’s father. “I sincerely thank the doctors at Amrita Hospital for completing this extremely complex surgery and giving my child a second chance at life,” he said.