Lucknow doctors save infant with rare jaw deformity | Lucknow News – Times of India


LUCKNOW: She was six-day old, grossly underweight with merely 1,900 grams and was gasping for breath due to her rare jaw deformityPierre Robin Sequence (PRS).
Daughter of a jawan posted in Jhansi, the military hospital initially referred the infant to the local government hospital, where the doctor informed the parents that the infant won’t survive more than a few days and asked them to take her back home.

On return, the jawan contacted officials of military hospital Jhansi, who then referred his daughter to command hospital Lucknow.
“When the infant arrived at our facility, she was gasping for every breath even though she was being supplied oxygen through a breathing tube. Born with PRS, an extremely rare birth defect with an underdeveloped jaw, backward displacement of the tongue and upper airway obstruction, the infant was saved after two surgeries,” said Brigadier Mukti Kanta Rath, consultant maxillofacial surgeon, who led the team of specialist including Colonel Ashutosh Kumar, the neonatologist, Colonel Badal Parikh, anesthesiologists, and Lt Col Vishal Kulkarni, maxillofacial Surgeon.
The girl has now completely recovered.
“Initially, we performed adhesion surgery of lip-tongue as an interim measure before main surgery. The tongue of the infant was near her throat. After five weeks, when the infant was fit for the major surgery for placement of a distractor (instruments used to move the lower jaw ahead), the anaesthesiologist used the state of the art video guided intubation to resort it. The baby’s small lower jaw was lengthened by over 10 mm by using the latest surgical technique called neonatal distraction histiogenesis (NDH),” said surgeon Rath who hails from Odisha.
This novel NDH surgical technique was developed by the legendary Russian Military Surgeon Gavriil Ilizarov to lengthen amputated limbs of Russian soldiers.
The technique has been successfully adapted by maxillofacial surgeons to lengthen the human jaws.
“The technique involves creating fractures on both sides of the jaw intentionally allowing it to heal for four-five days and gradually separating the jaws segments by stretching the healing tissue, thus harnessing the inherent biological potential. The lengthening of the lower jaw moved the tongue forward and opened the collapsed upper airway thus helping the baby to breathe normally,” said Rath.
It took more than three hours for the team to perform surgery.
For more than two months, nursing staff including Lt Col Rajni Mole, Major Khilota Devi and Captain Laxmi took care of the infant girl round the clock.
PRS affects one in 60,000 infants, and infants with such critical birth conditions rarely make it to their first birthday if not treated promptly.
Some 15 months back Brigadier Rath and his team had performed similar surgery on another infant girl who was brought from Jabalpur.

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