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Facial Trauma Surgery

Facial injuries following Road Traffic accident (RTA) require emergency care, acute treatment and long term reconstruction and rehabilitation not just for physical reasons but emotional as well.

Oral and Maxillofacial Surgeons are trained, skilled and uniquely qualified to manage and treat these Facial Trauma. Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a hands on experience and an understanding of how the treatment provided will influence the patients long term function and appearance.

Dr Manish & Dr Swathi meets and exceeds these modern standards. They are trained, skilled and uniquely qualified to manage and treat facial trauma. They are associated to various reputed hospitals and delivers emergency room coverage for facial injuries, which include the following conditions:

  • Facial Soft tissue lacerations
  • Fractured nasal (nose) bones
  • Fractured orbit (eye Socket)
  • Fractured Zygoma ( cheek Bones)
  • Fractured jaws (upper and lower jaw)
  • Intra oral lacerations
  • Avulsed (knocked out) teeth etc.

The Nature of Maxillofacial Trauma

There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries.

Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

Soft Tissue Injuries of the Maxillofacial Region

When soft tissue injuries such as lacerations occur on the face, they are repaired by suturing. In addition to the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands and salivary ducts (or outflow channels).

Dr. Manish & Dr. Swathi are well-trained oral and maxillofacial surgeon and is proficient at diagnosing and treating all types of facial lacerations.

Bone Injuries of the Maxillofacial Region

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, the age and general health of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary, are designed to be small and, whenever possible, are placed so that the resultant scar is hidden.

Trauma to the orbit

Any injury to the eye can be very devastating to the patient, at most of the occasions the bony socket of the eye bears the load and protects the globe of the eye.

This type of injury can seriously alter the volume (size) of the eye socket, movement of the eye and in some occasions it can also cause double vision.

At Manaswa, Dr Manish & Dr Swathi are exquisitely trained to do such complicated procedure and provide with the best outcome.

Trauma to the nose.

Nose plays a very important role in defining ones facial features. Many times injury to face can lead to fracture of nasal bones which may require advanced surgeries to correct them.

Injuries to the Teeth and Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out.

These types of injuries are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth.

Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.

Corrective Jaw Surgery

Corrective Jaw surgery or Orthognathic surgery is needed when the jaws don’t meet correctly and/or the teeth don’t seem to fit within the jaws.

Teeth are straightened with braces, and corrective jaw surgery repositions misaligned jaws. This process not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who needs orthognathic surgery?

People who can benefit from Jaw Surgery include those with an improper bite or jaws that are positioned incorrectly. Improper jaw positions can be a host of problems that can affect chewing function, speech, long-term oral health, obstructive sleep apnea, breathing problems, and appearance.

While orthodontics alone can correct bite problems if only the teeth are involved, orthognathic surgery may be required if the jaws also need repositioning.

Any of these can exist at birth or may be acquired after birth as a result of hereditary, environmental or traumatic influences. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays.

During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and us will make the decision to proceed with treatment together.

If you are a candidate for this corrective jaw surgery, our oral and maxillofacial surgeons will work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional and healthy dental-facial relationship.

Facial Aesthetic Surgery

Cleft Lip And Cleft Palate Repair

Cleft lip and cleft palate are congenital malformations that happen during early gestation at a rate of 1 in every 800 babies. These days, parents can feel at ease, knowing that oral and maxillofacial surgeons are trained to repair these conditions with great success and very favorable aesthetic outcomes.

Cleft Lip Surgery

The two sides of the face develop separately and then join together during pregnancy. In the case of a cleft lip, the two sides did not completely join together, leaving a separation on the lip that is not only noticeable, but can interfere with a child’s ability to suck, eat and speak. The cleft can occur on one side (unilateral), or both (bilateral). Surgery for cleft lips is typically performed before three months of age. Additional surgeries are sometimes needed to fix the nostril or gums if affected.

Cleft Palate Surgery

The “palate” is the roof of your mouth, and it is designed to separate the nasal cavity. This is very important for two reasons: 1) to keep food and fluids from entering the nasal cavity and 2) to keep air from blowing out of your nose during speech. The palate forms in a similar way to the lips – it is supposed to connect during pregnancy, but sometimes it doesn’t do so properly, forming a separation.

The repairing of a cleft palate typically requires several surgeries over the course of the child’s first 18 years. The first is often done between 7 and 18 months old. Goals of surgery include the closing of the gap or hole, the reconnection of muscles and the repair of the palate to ensure its proper functioning.

Complications With Cleft Palates

Sometimes children born with cleft palates may also have small chins or other craniofacial anomalies that may interfere with breathing or aesthetics. we will evaluate your child carefully to ensure the safest, most comprehensive plan for care.

Our Team

Cleft palate and cleft lip malformations often require more than one specialist to properly treat. Your child will have a great team of doctors and specialists, including Dr. Manish & Dr.Swathi, to ensure the best outcome in terms of function and aesthetics for a lifetime of happy smiles.

Parents are naturally very sensitive to these conditions, so we urge you to contact us with any questions about your child’s care!

Oral Cancer

Oral cancer is the 2nd most common cancer in India and more commonly seen in males. Tobacco consumption, including smokeless tobacco, betel-quid chewing, excessive alcohol consumption, unhygienic oral conditions and sustained viral infections including HPV (human papilloma virus ) are some of the risk aspects for incidence of oral cancer

Early diagnosis and prompt intervention can cure many of the oral cancers and improve the quality of life of the survivors.

@ Manaswa we specialize with oral cancer , its prevention, diagnosis and treatment with state of the art technologies including planning with stereolithographic models and 3d printing, all well before the surgical procedure. We have an imminent team specialized in reconstruction with microvascular surgeries for many of the cancer treatments.

TMJ Disorders

TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective

Trouble with Your Jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments.

Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth or trouble opening your mouth wide.

How to Know If You Have a TMJ Disorder?

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Do you have frequent headaches or neck aches?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat or yawn?
  • Have you ever injured your neck, head or jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes,” the more likely it is that you have a TMJ disorder

Understanding TMJ disorders will also help you understand how they are treated.

Treatment

There are various treatment options that we can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, we will determine the proper course of treatment.

It is important to note that treatment always works best with a team approach of self-care joined with professional care.

What about bite correction or surgery?

If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work.

Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed but are reserved for severe cases. We do not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.

Sleep Apnea

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs, the tongue is sucked against the back of the throat. This blocks the upper airway and airflow stops. When the oxygen level in the brain becomes low enough, the sleeper partially awakens, the obstruction in the throat clears, and the flow of air starts again, usually with a loud gasp.

Repeated cycles of decreased oxygenation lead to very serious cardiovascular problems. Additionally, these individuals suffer from excessive daytime sleepiness, depression, and loss of concentration.

Some patients have obstructions that are less severe called Upper Airway Resistance Syndrome (UARS). In either case, the individuals suffer many of the same symptoms.

The first step in treatment resides in recognition of the symptoms and seeking appropriate consultation. Oral and maxillofacial surgeons offer consultation and treatment options.

In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (skull x-ray) analysis, the doctors can ascertain the level of obstruction. Sometimes a naso-pharyngeal exam is done with a flexible fiber-optic camera. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight.

There are several treatment options available. An initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. One of the surgical options is an uvulo-palato-pharyngo-plasty (UPPP), which is performed in the back of the soft palate and throat. A similar procedure is sometimes done with the assistance of a laser and is called a laser assisted uvulo-palato-plasty (LAUPP). In other cases, a radio-frequency probe is utilized to tighten the soft palate.

In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (orthognathic surgery). This procedure is done in the hospital under general anesthesia and requires a one to two day overnight stay in the hospital.

OSA is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.

Dr. Manish Kumar Singh

Dr. Anjan Kumar Shah

Dr. Swati Iyengar Singh

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