Facial Paralysis – Reanimation by Temporalis and Fascia lata Dynamic Sling Surgery

Facial Paralysis – Reanimation by Temporalis and Fascia lata Dynamic Sling Surgery

Indian Academy of Maxillofacial Surgeons’ Advanced Craniofacial Surgery Workshop

The Indian Academy of Maxillofacial Surgeons conducted their Advanced Craniofacial Surgery workshop on “Current Advances in Cranio-Maxillofacial Surgery at Hitkarini Dental College and Hospital & Jabalpur Hospital and Research Centre, Jabalpur, on February 15-18, 2018. Many leading Cranio-Maxillofacial surgeons from around the world participated in this workshop. The programme director was Prof. J.N. Khanna and the programme coordinator was Dr. Rajesh Dhirawani.

Foreign Faculty at the Workshop

Prof. G. E. Ghali, Chancellor and Dean, LSU Health Sciences Center and Gamble Professor and Chairman, Oral and Maxillofacial Surgery -Shreveport, USA and his entire team of key opinion leaders played the role of mentors for this huge workshop. Other foreign faculty who were present at the workshop were Dr. Andrew Meram, Dr. Mary Laura Hastings, Dr. Ahmed Tamim and Dr. Hendell Nealy.

Dr. S.M. Balaji Invited for Demonstration of Congenital Facial Palsy Correction Surgery

Prof. Dr. S. M. Balaji was invited as a key operating faculty for this workshop. A case of congenital facial palsy was allotted to Prof. Dr. S. M. Balaji to demonstrate the facial reanimation procedure.

Planning for the Dynamic Temporalis Sling Surgery

The patient was a middle-aged male who had congenital facial palsy and facing a lot of health and social issues due to the facial palsy. Due to case selection and studies were performed. Considering all clinical and anatomical factors, a dynamic facial reanimation using Tensor fascia lata along with partial Tarsorrhaphy (surgery for joining of part of the upper and lower eyelids so as to partially close the eye) was planned.

There were about 200 postgraduates and young oral surgeons from across India as the audience. The surgery was planned as an interactive session where the audience asked questions to operate faculties.

Live Surgical Demonstration with Commentary by Prof. S.M. Balaji

The patient suffered from a congenital lower motor neuron type of paralysis. To correct this condition, a strip of fascia lata from the vastus lateralis was first harvested. The next step of the surgery was performed through a combined preauricular and intraoral approach. The insertion of temporalis into the coronoid process was released at the infratemporal area.

The zygomatic arch was carefully cut and pushed down to free the temporalis muscle. Care was taken to preserve all the vital structures such as the parotid duct and gland in this area. This action was carried out without disturbing the deep temporal artery and nerve. Then through careful manipulation, the lower end of temporalis was identified to which an end of the fascia lata was attached. Through a nasolabial incision, the modiolus was identified. The free end of fascia lata was split into three parts – the lower part was connected to muscles of the lower lip, the middle part to the modiolus and the upper part to the upper lip.

The connections were checked and ensured that the muscle attachments were secured and the dynamic facial reanimation was confirmed by the action of the muscles. To take care of the improper eye closure, a partial lateral tarsorrhaphy was performed. The patient recovered well.

Post-surgical Conference by Dr. S.M. Balaji

Prof. S. M. Balaji cleared doubts from the audience regarding the surgical procedure and carefully mentioned the tips for this kind of surgeries that he has learned over the years. The surgery was well-received by all at the workshop.

Dr. S.M. Balaji invited as key operating faculty to the Advanced Craniofacial Surgery Workshop of the Indian Academy of Maxillofacial Surgeons

Dr. S.M. Balaji invited as key operating faculty to the Advanced Craniofacial Surgery Workshop of the Indian Academy of Maxillofacial Surgeons

Indian Academy of Maxillofacial Surgeons’ Advanced Craniofacial Surgery Workshop

The Indian Academy of Maxillofacial Surgeons conducted a workshop in Jabalpur. It was an Advanced Craniofacial Surgery workshop. Topic was “Current Advances in Cranio-Maxillofacial Surgery”. Hitkarini Dental College and Hospital & Jabalpur Hospital and Research Centre were the hosts.

Duration of the workshop was from February 15-18, 2018. Many leading Cranio-Maxillofacial surgeons from around the world participated in this workshop. Prof J N Khanna was the programmed director. The programme coordinator was Dr Rajesh Dhirawani.

Craniofacial Surgery Workshop Indian Academy Of Maxillofacial Surgeons

Foreign Faculty at the Workshop

Prof G E Ghali, Chancellor & Dean, LSU Health Sciences Center was the chief mentor at the workshop. He is the Gamble Professor and Chairman, Oral and Maxillofacial Surgery -Shreveport, USA. Dr Ghali was present with his entire team of key opinion leaders at this huge workshop. Other foreign faculty were also present at the workshop. Prof Andrew Meram, Dr Mary Laura Hastings, Dr Ahmed Tamim and Dr Hendell Nealy were also present.

Prof G E Ghali Allotting The Case Of Congenital Facial Palsy To Prof S M Balaji

Dr S M Balaji Invited for Demonstration of Congenital Facial Palsy Correction Surgery

Prof S M Balaji was a key operating faculty at this workshop. His surgery was a case of congenital facial palsy. He taught the audience the finer aspects of the facial reanimation procedure.

Planning for the Dynamic Temporalis Sling Surgery

The patient was a middle aged male. He had congenital facial palsy and was facing a lot of health and social issues due to the facial palsy. Due case selection and studies were exacting and precise. Study of all clinical and anatomical factors was the basis of treatment planning. Inference was that a dynamic facial reanimation surgery would provide best results. This would be by means of using a Tensor fascia lata graft along with a partial Tarsorrhaphy. Surgery would join a part of the upper and lower eyelids. This would close the eye to a certain degree.

About 200 postgraduates and young oral surgeons presented for the workshop. They were from all over India. The surgery was a live demonstration. There was constant interaction between the surgeons and the audience. Audience would ask questions while the surgery was in progress. The operating faculties would immediately answer them.

Live Surgical Demonstration with Commentary by Prof S M Balaji

The patient suffered from a congenital lower motor neuron type of paralysis. Planned correct of this condition was via a strip of fascia lata. This was first harvested from the vastus lateralis. Next step of the surgery was by the combined preauricular and intraoral approach. Release of the temporalis from the coronoid process insertion was then performed. This was in the infratemporal region. The zygomatic arch was then cut and pushed down to free the temporalis muscle. Care was then taken to preserve all vital structures such as the parotid duct and gland in this area. Meticulous dissection ensured no damage to the the deep temporal artery and nerve. Through careful manipulation, the lower end of temporalis was then identified. One end of the fascia lata was then attached to it. Access to the modiolus was through a nasolabial incision. Free end of the fascia lata was then split into three parts. The lower part was then connected to the muscles of the lower lip. This was then followed by attaching the middle part to the modiolus and the upper part to the upper lip.

Dynamic facial reanimation check ensured proper connections and secure muscle attachments. This was through the action of the muscles. Movements were satisfactory. The connections were then checked again. Muscle attachments were secure and dynamic facial reanimation was fine. Confirmation of this was through the action of the muscles. A partial lateral tarsorrhaphy was then performed to correct improper eye closure. The patient recovered well.

Post-surgical Conference by Dr S M Balaji:

Prof S M Balaji’s interaction with the audience was educational and informative. The audience had a lot of questions about the procedure. The surgical tips he gave the audience about the case were very useful and practical. The audience was appreciative and the surgery was well received by all at the workshop.

Dr Ghali and Dr Dhirawani giving Dr S M Balaji a warm send off at the end of the workshop.
Dr Ghali And Dr Dhirawani Giving Dr S M Balaji A Warm Send Off

The 10th World Cleft Lip, Palate and Craniofacial Congress of the International Cleft Lip and Palate Foundation, was organized in Chennai

The 10th World Cleft Lip, Palate and Craniofacial Congress of the International Cleft Lip and Palate Foundation, was organized in Chennai

The 1st 2 days i.e. 24 & 25 Oct 2016 were the pre-conference Live Surgery workshop which was held in Balaji Dental and Craniofacial Hospital. In this workshop, world-renowned craniofacial surgeons performed free surgeries for children and adults suffering from complex skull and face deformities. Operating Faculty included Congress President & Hospital Director Prof. S.M. Balaji, Prof. GE Ghali, Chancellor & Dean, LSU Health Sciences Center, Gamble Professor & Chairman, Louisiana, USA, Prof. Kenneth Salyer, Founder & Chairman, World Craniofacial Foundation, Texas, USA (the eminent surgeon who separated the Egyptian twins conjoined in the head & who was on the team of doctors who tried to save President John Kennedy when shot) and Dr. Jason Dashow, LSU Health Sciences Center, Louisiana, USA.

The surgeries performed were transmitted live to doctors & trainee surgeons seated in the conference hall. This workshop provided a valuable opportunity for the participants to learn intricate surgical techniques and advanced procedures from the skilled international experts.