Zygoma Reduction Surgery for Fibrous dysplasia with protection of infraorbital nerve surgery
Presentation of fibrous dysplasia Fibrous dysplasia is a very rare disorder of the bone. The gene involved is the G-protein receptor. It is a condition where fibrous tissue replaces normal bone and marrow tissue. This results in bone that is very weak. There is also excessive proliferation of this fibrous bony tissue. This leads to increased size of the affected bone. Surgical correction is the only solution for fibrous dysplasia. A patient with fibrous dysplasia presents at Balaji Dental and Craniofacial Hospital This patient presented to Balaji Dental and Craniofacial Hospital for treatment. He had increased asymmetric growth of the right zygomatic bone. Dr S M Balaji, Craniomaxillofacial surgeon, examined the patient and ordered investigations. Biopsy revealed it to be fibrous dysplasia. He explained the condition to the patient and his treatment plan. The patient was in complete agreement with the treatment plan. Surgical correction of fibrous dysplasia Under general anesthesia, an incision was first made. This extended from the outer canthus of the right eye. Dissection was then carried down to the frontal part of the zygomatic bone. Next, a vestibular incision was then made in the right maxillary sulcus. Dissection was next carried down to the dysplastic zygomatic bone. Fibrous tissue of the zygomatic bone was next trimmed with burs and chisels. Access was through both incisions. Adequate trimming of fibrous tissue was then completed and facial symmetry restored. The incisions were then closed with sutures. Great care was always taken to preserve the infraorbital nerve. Testing of the nerve at the end of surgery revealed no neuropraxia or other signs of nerve injury. The patient expressed his happiness at the results of the surgery before discharge.
Occipital Protuberance of the skull Reduction Surgery
The patient’s friend refers him to Dr SM Balaji for deformity correction The patient is a young man with a bony unevenness in his posterior occipital region. This has been present ever since he can remember. He recently came to know from a friend that this irregularity could be set right. His friend referred him to Balaji Dental and Craniofacial Hospital, Teynampet, Chennai. Dr SM Balaji explains treatment plan to the patient He presented to our hospital and Dr S M Balaji, oral and maxillofacial surgeon, examined him. Dr S M Balaji ordered a 3D axial CT scan along with accompanying laboratory tests. He explained the surgical process to the patient. The patient was in complete agreement with the treatment plan. Surgical procedure performed on the patient Under general anesthesia, a 3 inch vertical incision was first marked out. This was over the irregularity in the occipital bone. The posterior scalp was first incised and reflected. The bone was then exposed and then trimmed using surgical burs until the surface was even and smooth. The incision was then closed in layers with sutures and staples. The patient expressed his satisfaction at the results of the surgery to Dr. Balaji. He was then discharged from the hospital. Surgery Video
Prof SM Balaji visited the Department of Oral and Maxillofacial Surgery, Stroger Hospital of Cook County, Chicago
Prof SM Balaji visited the Department of Oral and Maxillofacial Surgery, Stroger Hospital of Cook County, Chicago at the invitation of the Chairman of the department, Dr Henry C Fung as an observer. Prof SM Balaji is an eminent oral and maxillofacial surgeon in Chennai, India. He has a special interest in cleft lip and palate repair and surgical treatment of syndromic children afflicted with complex craniofacial defects.He travels extensively around the world in a constant quest to keep himself abreast with surgical innovations being practised in the best hospitals worldwide. Dr SM Balaji accompanied Dr Fung and his team of maxillofacial surgery residents during ward rounds. He also met with Dr James Murphy, Department of Oral and Maxillofacial Surgery and discussed the various oral and maxillofacial surgical procedures performed at the Stroger Hospital of Cook County, Chicago. Prof SM Balaji also visited the Operating Room as an observer. He observed Dr Henry Fung and Dr James Murphy operate on various Oral and Maxillofacial Surgery cases.
Prof SM Balaji visits the Maxillofacial Surgery Unit of Charite Universitatsmedizin Berlin as an observer
Prof SM Balaji visits the Charite Berlin at the personal invitation of Prof Adolphs Prof SM Balaji was invited by Prof Nicolai Adolphs to the Maxillofacial Surgery Unit of Charite Universitatsmedizin, Berlin. This was in recognition of Dr SM Balaji’s scientific contributions towards the advancement of cranio-maxillofacial surgery techniques. History of the Charite Berlin The Charite Universitatsmedizin Berlin was founded in 1818. It sustained some damage during World War II and was rebuilt at the end of the war. It was the most prestigious medical center of the German Democratic Republic. It was merged with the Freie Universitat of Berlin in 2003 and has since been one of the largest clinics in the whole of Europe. The Charite today is a premier surgical center for maxillofacial surgery in Germany. Prof SM Balaji views the functioning of the Charite Berlin from close quarters Prof Nikolai Adolphs is an eminent specialist oral and maxillofacial surgeon. He extended a personal invitation to Prof SM Balaji to visit the Charite as an observer. Prof SM Balaji attended the morning briefing session before ward rounds and also accompanied Prof Adolphs and his residents for the morning ward rounds. Prof SM Balaji was also invited into the operating room at the Charite to observe the surgical management protocols employed at the premier center. Prof Adolphs also invited Dr SM Balaji to his room at the Charite and showed him some of the memorabilia he had collected in relation to craniofacial surgery over the course of his distinguished surgical career. Prof Balaji also met with Prof Max Heiland, Director, Department of Maxillofacial Surgery, Charite Universitatsmedizin, Berlin
Prof SM Balaji attends Interactive Session on SCYLIMIT at Apollo Cancer Hospital, Chennai
Prof SM Balaji invited to Apollo Cancer Institute for SCYLIMIT interactive session The Department of Neurosurgery, Apollo Cancer Institute, Chennai invited Prof SM Balaji. This was for an interactive session on the SCYLIMIT system. The SCYLIMIT system is the brainchild of eminent neurosurgeon, Dr. Takeyoshi Shimoji. He is from Yamanishi, Japan. The Apollo Department of Telemedicine organized this session. Dr. Shimoji is a renowned trigonocephaly expert. He developed the SCYLIMIT system to detect and treat mild trigonocephaly. This was through cranioplasty surgery. Treatment of Mild Trigonocephaly with SCYLIMIT system Mild trigonocephaly results in increased intracranial pressure. This leads to many symptoms. These include language delay, hyperactivity, autistic tendencies, self mutilation and motor delays. The SCYLIMIT system causes no residual morbidity. It results in manifold improvement in the quality of life of the affected patients. There is also no residual postsurgical morbidity. Many doctors attended the session. They included eminent neurosurgeons Dr. Balamurugan and Dr. Samuel J K Abraham.
Palatonasal and Bucconasal Fistula Closure Surgery
Initial Presentation: The patient presented at Balaji Dental and Craniofacial Hospital, Teynampet, Chennai with complaints of regurgitation of fluids from the oral cavity into the nose for a very long time. The patient stated that there were “two holes” in the bone on the right side of his upper jaw. Diagnostic Tests: Dr. SM. Balaji, Cranio-Maxillofacial Surgeon, examined the patient and ordered radiographic studies for diagnostic confirmation. He explained to the patient that the “two holes” were oronasal fistula that were connections between the oral cavity and the nasal cavity. He further explained how these were causing the patient’s regurgitation problems. He added that surgical correction was the only solution for this. The patient was in agreement with this plan of treatment and was scheduled for surgery. Surgical Procedure: Under general anesthesia, a palatal flap was raised for closure of the palatonasal fistula. The epithelialized portion of the fistulous tract was excised and tissue was mobilized around the fistula, which was then closed with the palatal flap. Following this, a mucogingival flap was raised for closure of the bucconasal fistula. The epithelialized portion of the fistulous tract was excised followed by mobilization of the tissue around the fistula. The flap was then utilized to close the fistula. The patient was then extubated and recovered uneventfully from general anesthesia.
Prof S M Balaji at the First Live Surgery Symposium of the WPATH in New York City, USA
Prof S M Balaji attends WPATH Symposium at Icahn School of Medicine at Mount Sinai Prof SM Balaji, a registered member of the World Professional Association for Transgender Health (WPATH) and an experienced facial feminization surgery expert, was invited by the WPATH to attend the first live surgery symposium of the organization, organized at the Icahn School of Medicine at Mount Sinai, New York, USA. This symposium was jointly organized by the WPATH, Global Education Initiative (GEI), the Mount Sinai Health System and the American Society of Gender Surgeons (ASGS). WPATH rendering yeomen service to Transgender Health WPATH is a multispecialty organization of healthcare professionals who have made significant investments in their careers towards improving the quality of not just surgical care available to transgender individuals, but also the overall care encompassing the emotional and psychological needs of transgender individuals. Visionaries leading the WPATH for greater inclusiveness of all genders The WPATH is an organization that is lead by visionaries with long ranging goals for the organization. Dr. Gail Knudson is the President of the WPATH and Co-Chair of the GEI. She is also the Founder and former President of the Canadian Professional Association for Transgender Health (CPATH). Dr. Randi Ettner who is the Secretary of the WPATH, is a clinical and forensic psychologist of international renown. She has been a champion for transgender rights and has served in various committees, which have overseen the reformation of laws pertaining to the rights of transgender people. First Live Surgery Symposium of the WPATH The symposium was held over a period of three days with a wide variety of gender affirmation live surgical demonstrations performed by world leading experts. The facial feminization and tracheal shave live surgical demonstration was performed by Dr. Jeff Spiegel who is one of the foremost facial plastic surgery specialists in the world today. Dr. Loren Schechter provided an introduction to transgender surgery at the beginning of the session. Specialists attending the WPATH First Live Surgery Symposium Also present at the symposium were Dr. Joshua Safer who is the Executive Director of the Center for Transgender Medicine and Surgery at the Mount Sinai Hospital In New York City, Dr. Daniel Simon who is an eminent maxillofacial surgeon and has medical publications to his name in the field of Facial Feminization Surgery, Dr. Ravinder Jarial, Plastic and Reconstructive Surgeon, Florida and Dr. Cecile Unger whose live surgical demonstration of Vaginoplasty techniques and Penile Inversion surgery was very well received by the audience. Dr. Mark Courey who is a Professor of Otolaryngology and Head and Neck Surgery, Mount Sinai Health System was also present at the course as was Ms. Zil Goldstein who is an assistant professor of Medical Education at the Icahn School of Medicine. Prof Balaji attends the WPATH as an expert in facial feminization surgery Prof S M Balaji who is an expert at facial feminization surgery and has performed over 100 such surgeries at Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, met with the various experts and held extensive discussions with them regarding the recent advancements made in the fields related to facial feminization surgery.
Outstanding Research Faculty Award by Careers360
The success for an experienced surgeon is to see that his knowledge, skills, experience and lifelong learning is being passed to next generation of young doctors. In pursuit of this, many doctors document their experience in the form of research publications and opinion pieces. Our Hospital Director, Prof SM Balaji also continuously documents his experience in Oral and Maxillofacial Surgery and dentistry in the form of publications. He often documents his unique procedures, his modifications and approach and willingly shares them on several platforms. His works has been archived at several repositories including PUBMED CENTRAL, SCOPUS, RESEARCHGATE. Many young surgeons and researchers across India and world access and refer his publications for their research and cite Prof. S. M. Balaji work in their works. Career 360, (https://www.careers360.com/) a professional mentoring company that helps students to take informed decision for choosing career, recently undertook a valiant effort to identify most influential researchers in each professional stream across India. Our Director, Prof. S. M. Balaji was judged to be one of ten top most leading dental professionals in terms of research output in India. The selection was based on a composite score generated by evaluating your academic output in SCOPUS indexed journals for the year 2015-17, citation count and h-index. The weights for output, citation and h-index are 33.5, 31.6, and 34.9% respectively. This was arrived at by averaging of differential weights assigned by a postal ballot from the top 20 academics of Indian origin including Innovation Guru Prof. R A Mashelkar, celebrated corporate advisor cum academician Prof. Nirmalya Kumar, Harvard Business School Dean Dr Nitin Nohria, renowned academician and institution-builder Dr Pritam Singh, and National Law University Bangalore Vice-Chancellor Dr R Venkata Rao. Prof. S. M. Balaji’s contribution to the field of dentistry and dental research is acknowledged by a private foundation in a public forum
Successful Correction of Primary Incomplete Cleft Lip Defect
A 3-months-old baby girl from Delhi was brought to our hospital. The parents complained about her deformed lip, nose and requested to correct the same. They were worried about their baby girl’s appearance. The baby was diagnosed with incomplete cleft lip. Maxillofacial Surgeon Dr. S.M. Balaji planned to correct the lip and nose defect surgically. The primary cleft lip repair was done using modified Millard’s technique. Primary rhinoplasty was also done. The baby’s appearance improved greatly. Her parents were overjoyed to have the defect treated with negligible scar formation.
Unilateral Cleft Lip Correction Surgery – Dr. SM Balaji, Maxillofacial Surgeon, India
Baby boy is born with a unilateral cleft lip and palate: This baby boy is the grandson of a famous merchant in Bangalore, Karnataka. He was born with a severe form of unilateral cleft lip and palate. There was a wide cleft space with ill developed segments. Balaji Dental and Craniofacial Hospital, a world-renowned cleft surgery centre: The family searched far and wide for the best cleft surgeon in India. They made enquiries all over the country, including all metro cities. Friends too joined in the search for the best hospital. One friend finally zeroed in on Balaji Dental and Craniofacial Hospital in Chennai. Further enquiries revealed it to be a world-renowned centre for cleft correction. The parents then made discreet enquiries about the hospital. Once satisfied, they presented at our hospital for repair of the cleft deformity. Dr SM Balaji, Cranio-maxillofacial surgeon, examined the baby. He decided to perform a modified Millard’s Technique to repair this baby’s cleft lip defect. Dr Balaji explained this to the parents in detail. The parents consented to the operation. Perfect adaptation of the cleft halves of the upper lip: A modified Millard’s technique leads to less scarring. It also gives better functional and esthetical results. Customization of the approach depends upon the degree of cleft and muscular involvement. Being ambidextrous (the ability to work with both hands) is an advantage for this surgery. A modified Millard’s flap was first employed. The C flap was then used to recreate the nasal sill while the M flap was next used to create the floor of the nose. All tissues were well used in the reconstruction and there was no tissue wastage. There was a perfect adaptation of the two halves of the cleft. Need for further surgeries explained to the parents: The need for further surgeries was then explained to the parents. This would be necessary for the complete rehabilitation of the baby’s deformities. Surgery Video